Sinusoidal endotheliitis as a histological parameter for diagnosing acute liver allograft rejection

Figure 1 Spectrum of portal and central venous pathologic findings. A: Intact portal triad; B: Portal inflammation with intact venule; C: Portal vein with subendothelial lymphocytic infiltration (endotheliitis); D: Severe endotheliitis with perivenular hepatocyte necrosis (hematoxylin-eosin staining, magnification × 400).

Figure 2 Spectrum of sinusoidal pathology. A: lymphocytes in sinusoidal spaces, with adhesion to endothelium but without lifting of endothelial cells; B: Grade 1 sinusoidal endotheliitis with subendothelial linear lymphocytic infiltration; C: Grade 2 sinusoidal endotheliitis with subendothelial lymphocyte clusters and partially disrupted endothelium; D: Grade 3 sinusoidal endotheliitis with endothelial damage, fresh hemorrhage, lymphohistiocytic infiltration and adjacent liver cell necrosis; E: Grade 3 sinusoidal endotheliitis with collapsed liver cell plates on reticulin staining; F: Grade 3 sinusoidal endotheliitis with collagen deposition on Masson trichrome staining (hematoxylin-eosin staining, magnification × 400).

Figure 3 Correlation between scores of sinusoidal endotheliitis and the rejection activity index of the Banff schema. A: The sinusoidal endotheliitis score (SES) moderately correlates with the overall rejection activity index; B: The SES strongly correlates with the portal and central vein endotheliitis activity score (hematoxylin-eosin staining, magnification × 400).