Central perivenulitis: A common and potentially important finding in late posttransplant liver biopsies

✍ Scribed by Stefan G. Hübscher

• Publisher: John Wiley and Sons
• Year: 2008
• Tongue: English
• Weight: 80 KB
• Volume: 14
• Category: Article
• ISSN: 1527-6465
• DOI: 10.1002/lt.21451

✦ Synopsis

The term central perivenulitis (CP) emerged from discussions held by the Banff Working Party at the 8th Banff Conference on Allograft Pathology in Edmonton, Canada, in July 2005. 1 It is used to describe a spectrum of inflammatory lesions involving perivenular regions of the liver parenchyma that are in most cases thought to be a manifestation of liver allograft rejection. Other related terms that have been used previously include centrilobular necrosis, 2-7 central venulitis, 8,9 hepatitic phase of rejection, 10 centrilobular inflammation, 11 centrilobular necroinflammation, 12 centrilobular changes, 13 centrilobular alterations, 14 and centrilobular injury. 15 At one end of the histological spectrum of CP, usually occurring within the first few weeks of liver transplantation, perivenular inflammation is typically seen in association with characteristic portal tract changes of acute rejection and often also involves the endothelium of hepatic veins. In such cases, a diagnosis of rejection is straightforward, and rejection is usually graded as severe according to the Banff criteria. 7,16 More frequently, features of CP are seen in patients presenting with graft dysfunction several months or more following transplantation. In such cases, hepatic venous endothelial inflammation is rarely conspicuous. Portal tract inflammation is also variable in severity and composition and often lacks features typically seen in early acute cellular rejection (ACR). In cases where portal inflammation is absent or lacks typical features of ACR, the term isolated central perivenulitis (ICP) may be