Liver transplantation is the treatment of choice in patients with late-stage PBC. Indications are decompensated cirrhosis with treatment-resistant ascites, recurrent spontaneous bacterial peritonitis, encephalopathy, recurrent variceal bleeding, or hepatocellular carcinoma. In highly selected patients (see above), treatment-resistant pruritus in the absence of decompensated cirrhosis may be an indication for transplantation, and so is severe osteoporosis [28, 331] . Survival rates of 80% to 90% at 5 years have been reported. The disease recurs in up to 30% at 10 years after transplantation, but then usually displays a mild course under immunosuppressive treatment [331] .