Acute and Chronic Rejection in the Liver Allograft What Is Their Relationship?

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Acute and chronic rejection remain important complications of liver transplantation. A case of severe liver allograft rejection resulting in rapidly progressive graft failureis presented here. Needle biopsies taken 7, 14 and 21 days post-transplantation and the hepatectomy specimen obtained at retransplantation 39 days post-transplantation all showed histologic features of acute (cellular)and chronic (ductopenic) rejection. The possible relationship from the presented case also showed striking changes involving perivenular (zone 3) regions. The pathogenesis and functional significance of these zone 3 lesions in rejecting liver allografts is also discussed.

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