Liver and intrahepatic bile ducts - nontumor
Acute graft rejection

Author: Komal Arora, M.D. (see Authors page)

Revised: 13 November 2017, last major update May 2012

Copyright: (c) 2002-2017,, Inc.

PubMed Search: Acute rejection[TI] liver[TI] free full text[sb]

Cite this page: Arora, K. Acute graft rejection. website. Accessed March 21st, 2018.
Definition / general
  • 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)
Microscopic (histologic) 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
Microscopic (histologic) images

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Moderate acute rejection with bile duct damage

Severe acute rejection

Loss of bile ducts