How Important Is acute cellular rejection?

The impact of ACR on key outcomes after LT varies with the etiology of liver disease. There is a strong rationale for avoiding treatment-requiring ACR in patients with an HCV infection. In contrast, a single treated episode of mild ACR is associated with a favorable posttransplant course in patients without an HCV infection. Because immunosuppression contributes to many of the causes of posttransplant morbidity and mortality, such as renal failure, malignancies, and metabolic syndrome, the magnitude and type of immunosuppression employed to prevent rejection need to be balanced against the medium- and long-term consequences of immunosuppressive agents.