Chronic Rejection of Transplanted Liver
Differential Diagnosis
| Acute Rejection of Liver | Chronic Rejection of Liver |
|---|---|
| 1 week to 1 year post-transplant | Presents > 6-12 months post-transplant |
| Bile duct lymphocytic infiltrate | Bile duct loss in at least 50% of portal tracts |
| No cholestasis unless extensive bile duct damage | Centrilobular cholestasis |
| No hepatocyte swelling | Centrilobular hepatocyte swelling |
| No apoptotic bodies in lobules | Scattered apoptotic bodies may be present |
Diseases with a significant incidence of recurrence in transplants
- Autoimmune hepatitis
- Hepatocellular carcinoma
- Primary biliary cirrhosis
- Can be impossible to distinguish from chronic rejection on histology
- Primary sclerosing cholangitis
- Viral hepatitis B
- Viral hepatitis C
