Features of rejection were found in 21 needle biopsies obtained from seven patients after liver transplantation. Wedge biopsies taken peroperatively were used as a baseline for comparison. Rejection was diagnosed by excluding other known causes of graft dysfunction using appropriate methods. In cases in which these criteria were fulfilled a consistent picture of rejection was seen, and this was useful in clinical management. Two features constantly present in cases of acute rejection were: a dense mixed portal inflammatory infiltrate; and polymorphonuclear infiltration of biliary epithelium.
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