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Figure 1. A 49-year-old man underwent liver transplantation in 1989 for alcoholic cirrhosis. In 1994, ischemic cholangitis developed with strictures and signs of ascending cholangitis, leading to a second transplantation. Three weeks later, blood cultures were positive for Clostridium clostridiiforme. Angiography and ultrasonography revealed hepatic-artery thrombosis. A computed tomographic scan (Panel A) of the second allograft showed intrahepatic cavities. A culture from a cavity contained Enterococcus faecalis and coagulase-negative staphylococci. Because of these complications, the second allograft had to be removed. The specimen contained large, multiloculated ischemic infarcts with extensive central cavitation (Panel B). The patient is doing . . . [Full Text of this Article] |