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Medline ® Abstract for Reference 44

of 'Liver transplantation: Diagnosis of acute cellular rejection'

Cholestatic jaundice after hepatic transplantation. A nonimmunologically mediated event.
Williams JW, Vera S, Peters TG, Van Voorst S, Britt LG, Dean PJ, Haggitt R, Massie JD
Am J Surg. 1986;151(1):65.
Serial liver biopsy and close clinical monitoring in 55 consecutive hepatic allografts have disclosed a syndrome of cholestatic jaundice that simulates rejection. This syndrome is associated with distinct histologic findings and resolves spontaneously without modification of immunosuppressive management. The cause of the cholestasis is probably related to subcellular organelle damage produced by cold ischemia, and its importance stems from the confusion it creates with regard to rejection diagnosis. Recognition of this syndrome can result in decreased immunosuppression in hepatic allograft recipients, a secondary decrease in infectious complications, and improvement in the survival rate.