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Liver and intrahepatic bile ducts-nontumor


Acute graft rejection

Reviewers: Komal Arora, M.D. (see Reviewers page)
Revised: 22 May 2012, last major update May 2012
Copyright: (c) 2004-2012, PathologyOutlines.com, Inc.


● Cell mediated, potentially reversible
● Either resolves or progresses to chronic graft rejection
Banff International Consensus Document criteria: mixed portal inflammation, cholangiolitis and endothelialitis (Hepatology 1997;25:658, Hepatology 2006;44:489)


● Cautious increase in immunosuppression (even if posttransplant lymphoproliferative disorder)

Micro description

● Portal infiltrate of lymphocytes and variable eosinophils and neutrophils that damage bile ducts and venous endothelium
● No/minimal hepatocyte damage
● Also loss of bile ducts, arteritis, central ischemic damage with ballooning degeneration and hepatocyte dropout

Micro images

Moderate acute rejection with bile duct damage

Severe acute rejection

Loss of bile ducts

Differential diagnosis

EBV associated hepatitis
Hepatitis C
Primary biliary cirrhosis
Terbinafine drug reaction

End of Liver and intrahepatic bile ducts-nontumor > Transplantation > Acute graft rejection

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