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Contributed by
A.J. Demetris, M.D.
There is mild focal interface activity.
Throughout the lobules there is prominent Kupffer' s cell hypertrophy, mild lobular disarray, a noticeable increase in sinusoidal inflammatory cells and spotty acidophilic necrosis of hepatocytes. Mild hepatocellular swelling is also seen. No viral inclusions or ground glass cells are seen.
Overall, the histopathological changes are most consistent with the lobular phase of recurrent hepatitis C. This contention is based on the time after transplantation, the relatively high levels of virus in the blood, and the histopathological features. More specifically, the lobular changes predominate over those seen in the portal tracts. While portal tract inflammation is present and there is focal bile duct damage, many other ducts are relatively normal in appearance, and particularly, they do not show reactive changes as might be observed with a more significant rejection reaction. While I cannot exclude a mild component of rejection, it is my opinion that the hepatitic component is the more significant finding at this time.
TPIS Related Resources:
Hepatitis C in the Liver Allograft Recipient
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