Successful Treatment of Recurrent Primary Sclerosing Cholangitis after Orthotopic Liver Transplantation with Oral Vancomycin

Figure 1

Liver and colon biopsies (stained with trichomere): thoracic liver before OLT: (a) onion skin fibrosis and periductular inflammation; (b) cirrhosis nodules surrounded by normal tissue; after OLT with recurrence of PSC (c) periductular fibrosis and inflammation; (d) damaged bile ductules noted with arrows; after  Vancomycin treatment with no immune suppression (e) normal bile ducts; (f) resolution of portal space ductile damage. Biopsies from (g) descending colon (100x) and (h) sigmoidal colon (200x) show mild irregularities in the contours of the crypts, mild loss of mucin, and evidence of cryptitis with neutrophilic infiltrate within the crypt epithelium.

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