Pediatric liver transplantation

Figure 14 Acute cellular rejection: histopathological findings and grading. A: Mild acute cellular rejection, portal tracts are mildly expanded because of a predominantly mononuclear, but mixed portal inflammation. Rejection infiltrate is composed of blastic and small lymphocytes, eosinophils, macrophages, and occasional plasma cells. Lymphocytes are also present inside the basement membrane of the small bile ducts and in the subendothelial space of small portal vein branches. B: Moderate acute cellular rejection, all the portal tracts are markedly expanded by a predominantly mononuclear, but mixed inflammation. Centrilobular inflammation and hepatocyte necrosis and dropout are absent. C: evere acute cellular rejection, severe expansion of the portal tracts because of inflammation with focal portal-to-portal bridging; perivenular inflammation with hepatocyte necrosis and dropout; inflammation and damage to small bile ducts.