Histologic Features of Early and Late Chronic Liver Allograft Rejection
Structure	Early CR	Late CR
Small bile ducts (<60 um)	Degenerative 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) Bile duct loss <50% of portal tracts	Degenerative changes in remaining bile ducts Loss in >=50% of portal tracts
Terminal hepatic venules and zone 3 hepatocytes	Intimal/lumenal inflammation Lytic zone 3 necrosis and inflammation Mild perivenular fibrosis	Focal obliteration Variable inflammation Severe (bridging) fibrosis
Portal tract hepatic arterioles	Occasional loss involving <25% of portal tracts	Loss involving >25% of portal tracts
Other	So-called "transition" hepatitis with spotty necrosis of hepatocytes	Sinusoidal foam cell accumulation; marked cholestasis
Large perihilar hepatic artery branches	Intimal inflammation, focal foam cell deposition without lumenal compromise	Lumenal narrowing by subintimal foam cells Fibrointimal proliferation
Large perihilar bile ducts	Inflammation damage and focal foam cell deposition	Mural fibrosis

Reference

Demetris A, Adams D, Bellamy C, Blakolmer K, Clouston A, Dhillon AP, Fung J, Gouw A, Gustafsson B, Haga H, Harrison D, Hart J, Hubscher S, Jaffe R, Khettry U, Lassman C, Lewin K, Martinez O, Nakazawa Y, Neil D, Pappo O, Parizhskaya M, Randhawa P, Rasoul-Rockenschaub S, Reinholt F, Reynes M, Robert M, Tsamandas A, Wanless I, Wiesner R, Wernerson A, Wrba F, Wyatt J, Yamabe H. : Update of the International Banff Schema for Liver Allograft Rejection: Working Recommendations for the Histopathologic Staging and Reporting of Chronic Rejection Hepatology 31(3):792-799, 2000

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