Decompensated cirrhosis due to nonalcoholic steatohepatitis (NASH), and autoimmune liver diseases (AILD) are the most common indications for liver transplantation (LT). AILD include autoimmune hepatitis (AIH), primary biliary cholangitis (PBC), and primary sclerosing cholangitis (PSC). NASH and AILD share some peculiarities as they can recur in the new graft, compromising the quality of life, and graft and patient survival. De novo NASH or AIH connotes the development of these liver diseases in patients transplanted for other indications. The diagnosis of recurrent or de novo liver disease usually requires a liver biopsy aside from recurrent PSC, which can be diagnosed with compatible imaging studies and exclusion of other causes of biliary strictures. The treatment of recurrent NASH is lifestyle modifications aiming for weight loss. Recurrent and de novo AIH is usually treated with corticosteroids with or without azathioprine. Recurrent PBC should be treated with ursodeoxycholic acid. There are no proven treatment options for recurrent PSC. Patients with graft failure should be considered for repeat LT. Future investigations should use standardized diagnostic criteria for each disease, seek diagnostic biomarkers, and evaluate treatments that improve outcomes.

非酒精性脂肪性肝炎（NASH）引起的代偿性肝硬化和自身免疫性肝病（AILD）是肝移植（LT）的最常见适应症。AILD包括自身免疫性肝炎（AIH），原发性胆源性胆管炎（PBC）和原发性硬化性胆管炎（PSC）。NASH和AILD具有一些特殊之处，因为它们可以在新的移植物中复发，从而降低了生活质量以及移植物和患者的生存率。从头开始NASH或AIH暗示了在移植有其他适应症的患者中这些肝病的发生。复发或从头诊断肝病除了需要反复进行PSC之外，通常还需要进行肝活检，这可以通过兼容的影像学检查和排除胆管狭窄的其他原因来诊断。复发性NASH的治疗是旨在减轻体重的生活方式。复发性和从头开始AIH通常用有或没有硫唑嘌呤的皮质类固醇治疗。复发的PBC应使用熊去氧胆酸治疗。没有经过验证的复发性PSC治疗方案。移植失败的患者应考虑重复LT。未来的调查应针对每种疾病使用标准化的诊断标准，寻找诊断性生物标志物，并评估可改善结果的治疗方法。