Elsevier

Hepatology

Volume 22, Issue 2, August 1995, Pages 648-654
Hepatology

Special article
Terminology for hepatic allograft rejection

https://doi.org/10.1016/0270-9139(95)90591-XGet rights and content

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      The distinction is clinically important because early chronic rejection is potentially reversible, whereas late stage rejection is generally considered irreversible and usually requires retransplantation. To make an accurate assessment for the degree of ductopenia, 20 or more portal tracts should be assessed, which sometimes requires more than 1 biopsy over time.54 However, there is evidence that ductopenic chronic rejection can be diagnosed reliably by experienced pathologists based on assessment of considerably fewer portal tracts.55

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      Both early and late TCMR show the classic histologic features described earlier but the latter also shows central perivenulitis with associated necrosis, less bile duct injury, and a more homogeneous inflammatory infiltrate of histiocytes, lymphocytes, and plasma cells with mild interface activity.17,24 AMR is caused by preformed antidonor antibodies, ABO incompatibilities, or de-novo antibodies that develop after transplant.27–31 Preformed antidonor antibodies either bind to ABO antigens or to HLA class I and class II antigens expressed on endothelial cells.

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    Prepared by a panel of an International Working Party on the Terminology of Chronic Hepatitis, Hepatic Allograft Rejection, and Nodular Lesions of the Liver. The working party was organized and funded by the World Congresses of Gastroenterology, Los Angeles, 1994. (Program Chair: Douglas B. McGill, MD) The material was presented in part at that meeting. See appendix for a list of panel members.

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