case_images: PMC3504272_01
case_images: Serial liver tests for patient Mr. X. Bilirubin (Normal: 3-24 umol/L), ALP: Alkaline phosphatase (Normal: 32-103 U/L), ALT: alanine transaminase (Normal: 7-36 U/L), AST: aspartate transaminase (Normal: 15-33 U/L), GGT: gamma-glutamyl transferase (Normal: 11-63 U/L).
case_images: CRIM.TRANSPLANTATION2011-654792.001.jpg
case_images: PMC3504272_01_CRIM.TRANSPLANTATION2011-654792.001.jpg
case_images: fig1
case_images: He was noticed to be deeply jaundiced with a mixed cholestatic-hepatitic picture on his liver tests (see Table 1 and Figure 1). 
case_images: Histomicrograph of liver biopsy in December 2009.
case_images: CRIM.TRANSPLANTATION2011-654792.002.jpg
case_images: PMC3504272_01_CRIM.TRANSPLANTATION2011-654792.002.jpg
case_images: fig2
case_images: A liver biopsy was performed in December 2009 that demonstrated moderate acute cellular rejection (rejection activity index score 5) (Figure 2(a)). Repeat biopsy performed 2 weeks later confirmed good histological response of the acute cellular rejection to steroid pulses (Figure 2(b)).
case_images: Histomicrograph of liver biopsy in February 2010.
case_images: CRIM.TRANSPLANTATION2011-654792.003.jpg
case_images: PMC3504272_01_CRIM.TRANSPLANTATION2011-654792.003.jpg
case_images: fig3
case_images: However, liver function tests did not improve, and a third liver biopsy in February 2010 demonstrated only lymphocytic portal and lobular hepatitis with marked cholestasis, without acute or chronic graft rejection (Figure 3).