Late Bile Duct and Parenchymal Changes in Chronic Liver Allograft Rejection

In the later stages of chronic rejection, there may be only mild or even no portal inflammation. Bile ducts loss affects > 50 % of the portal tracts, and any remaining ducts usually continue to show atrophy and pyknosis. Within the lobules, cholestasis, foam cell clusters and moderate to severe (bridging) perivenular fibrosis appear. However, a classic cirrhosis, with portal-to-portal bridging fibrosis; fibrous septae containing proliferating cholangioles; and regenerative nodules is uncommon in our experience.

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