Figure 2. Severe bile duct(BD) damage is the most prominent feature of the early phase of chronic rejection. It is characterized by eosinophilic transformation of the cytoplasm and uneven nuclear spacing. Nuclear enlargement and irregularity similar to that seen in bile epithelial cell dysplasia can also be seen. The severe duct damage is seen in more than an occasional bile duct and is invariably associated with markedly increased serum levels of g-glutamyl transpeptidase.