After an acute cellular rejection episode, which change to the immunosuppression regimen is recommended?

Increasing the prednisone dosage after an acute cellular rejection episode is a common practice in managing the situation. Prednisone is a corticosteroid that helps to quickly reduce inflammation and suppress the immune response, which is critical in preventing further rejection incidents.

Switching immunosuppressants, such as changing cyclosporine to tacrolimus, is also a potential strategy after a rejection episode. Tacrolimus has a different mechanism of action and may offer enhanced immunosuppressive efficacy compared to cyclosporine, potentially leading to better outcomes in patients who have experienced rejection. This switch is particularly beneficial when there are concerns about the patient's compliance with the current regimen or when there is a need for a more effective agent to tailor the immunosuppressive strategy.

Overall, increasing the dosage of prednisone directly addresses the immediate concern of inflammation and rejection risk, while the switch to tacrolimus represents a long-term strategy aimed at improving the patient's overall immunosuppressive regimen.