Table 1.

Differential Diagnosis of Acute and Chronic Rejection.

Category	Etiology	Time after liver transplantation
Surgical issues	Hepatic artery thrombosis Biliary issues	More common in early period Any time
Infections	Cytomegalovirus, atypical viral infections	Higher chances in early months
Rejection	Acute cellular rejection Chronic rejection (CR) Antibody mediated Plasma cell rich rejection	Any time after liver transplantation, majority of ACR occur early (initial 3 months) CR occur late (months to years) Evolving literature on antibody mediated rejection Plasma cell rich rejection occurs after months to years
Recurrence of primary disease	Hepatitis B, hepatitis C, non-alcoholic steatohepatitis, autoimmune hepatitis, primary biliary cirrhosis, primary sclerosing cholangitis, autoimmune hepatitis	Generally >1 year after liver transplantation, viral can manifest any time