European Grading System for Acute Liver Allograft Rejection
Portal inflammatory changes are generally mild
and patchily distributed. Bile duct damage and venous endothelial
inflammation are both mild.
Portal inflammatory changes are more severe and
widespread. Bile duct damage and venous endothelial
inflammation both conspicuous.
All three classical features of acute rejection
are present to a marked degree. They may be accompanied by additional
periportal, or vascular changes as outlined below.
The severity of 1) portal inflammation, 2) bile duct
damage, and 3) venous endothelial inflammation are graded on a scale
of 0 = none to 3 = severe and are then collated to provide a final
rejection grade. In some cases additional features, which are seen
inconsistently in acute rejection (eg. portal inflammatory spillover,
sinusoidal endotheliitis, parenchymal inflammation Â± necrosis,
arteritis), may be used to upgrade the overall severity of acute