Biliary tract complications are a common source of histopathological
changes in the liver allograft and are identical to those seen in
non-allograft livers. Complications recognizable on light microscopy
include biliary stricturing and/or obstruction, ascending cholangitis,
hemobilia, biliary-vascular fistulas and viral infections. It should
be stressed however, that incomplete biliary tract obstruction can
produce changes that mimic both acute rejection and viral hepatitis,
particularly when the patient has survived for more than one year
after transplantation. Therefore, close clinical correlation, including
the results of recent cholangiographic studies and liver injury tests
is needed.
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