Histologic Features of Early and Late Chronic Liver Allograft Rejection and Suggested Fibrosis Scoring
Structure
Early CR
Late CR
Small bile ducts
(<60 um)
Senescence-related changes involving a
majority of ducts (eosinophilic transformation of the cytoplasm; increased N:C
ratio; nuclear hyperchromasia; uneven nuclear spacing; ducts only partially
lined by biliary epithelial cells)
Inflammation damage and focal foam cell
deposition
Mural fibrosis
Suggested Fibrosis Scoring
Score as 0 to 3 for the following: Portal/periportal: 0 (none) to 3 (portal-portal or portal-central bridging) Subsinusoidal: 0 (none) to 3 (marked and diffuse) Perivenular: 0 (none) to 3 (central-central or central-portal bridging)
Final score is the sum of the scores, ranging from 0-9 Recording the individual scores is also desirable.
References
Demetris AJ et al. 2016 Comprehensive Update of the Banff Working Group on Liver Allograft Pathology: Introduction of antibody-mediated rejection. Am J Transplant 2016;16:2816-28335
Venturi C et al. Novel histologic scoring system for long-term allograft fibrosis after liver transplantation in children. Am J Transplant 2012; 12:2986-2996