Ischemic Cholangiopathy Post Liver Transplantation: A Clinical Case

Ischemic cholangiopathy (IC) post liver transplant (LT) is not a rare condition, it should be suspected and treated, if possible, without delay. We report a case of a 69-year-old man who underwent LT without any instability, vascular, infectious or graft disorders, but 15 months after LT, had cholangitis with stenting of the biliary tract. One year later, he had a new episode of cholangitis, with stenosis of the left main duct and peripheral poverty of the biliary tract and developed graft failure. Despite optimal medical and endoscopic treatment, the patient died. This case illustrates how, sometimes, IC course can be asymptomatic and insidiously, with posterior graft failure even with appropriate endoscopic management. Early recognition and a prompt referral are essential because re-transplantation could be an option in this situation.