Progress in the diagnosis and treatment of graft fibrosis after liver transplantation

Liver transplantation (LT) is considered one of the best treatments for patients with end-stage liver diseases. However, some patients with no significant clinical manifestations or abnormal laboratory tests still experience graft fibrosis during postoperative follow-up, which is often recognized by graft histopathology. Graft fibrosis can lead to graft dysfunction, thereby reducing the survival time of the recipient and even requiring re-transplantation. Currently, noninvasive methods are widely applied in the assessment of hepatic and allograft fibrosis. Although both noninvasive diagnostic models based on laboratory examination indicators and elastography technology that can quantify liver stiffness have some value in the evaluation of fibrosis, the diagnostic accuracy and characteristics of these various methods vary and cannot replace liver biopsy completely. In recent years, some liver-protective drugs and proprietary Chinese traditional medicines have been proven to delay or reverse chronic liver fibrosis. Nevertheless, their efficacy and safety for LT recipients need to be further verified. This article reviews the diagnosis and treatment of graft fibrosis after LT to provide a reference for improving the overall survival rate of LT recipients.