The timing of liver transplantation in primary biliary cirrhosis

Primary biliary cirrhosis, the most common chronic cholestatic liver diseas e in adults, usually progresses to cirrhosis and its complications. Ursodeo xycholic acid therapy delays disease progression, but most patients will ul timately succumb. Liver transplantation is now accepted as the standard tre atment for end-stage PBC. Development of major complications of portal hype rtension and liver failure, poor quality of life and short survival without transplantation are the major indications for this surgical intervention i n patients with primary biliary cirrhosis. Resource use is another key vari able to be considered in the timing of liver transplantation. Prognostic mo dels have been developed to predict survival and resource utilization with and without liver transplantation. Prognostic models aid the clinician in t he selection and timing of liver transplantation in the patient with primar y biliary cirrhosis.