In the absence of any other obvious cause, it is possible that some cases of PTCH may represent a form of late cellular rejection. The majority of patients with a diagnosis of chronic hepatitis in a protocol biopsy are clinically well with normal or near normal liver biochemistry. Some patients who have become symptomatic with significant transaminitis, have been treated with corticosteroids resulting in clinical and biochemical improvement. A small number of cases have been unresponsive to immunosuppression progressing to graft failure requiring retransplantation. In conclusion, chronic hepatitis of unknown aetiology continues to be a common diagnosis in biopsies obtained from liver allograft recipients surviving more than 12 months following liver transplantation.
Most cases appear to have little impact on graft function or patient survival.
However some symptomatic cases require additional immunosuppression and a few are associated with progressive fibrosis resulting in cirrhosis. Further studies are required to determine the aetiology of this lesion, including its relationship with rejection, and the behaviour of chronic hepatitis over a longer period of follow up. All rights reserved. Unauthorized redistribution prohibited.