In the case of a patient with moderate acute cellular rejection, what is the most appropriate initial management?

In cases of moderate acute cellular rejection in transplant recipients, the initial management typically involves the use of high-dose corticosteroids. Administering prednisone at a dose of 50 mg is aligned with the common practice of treating acute rejection episodes. Corticosteroids rapidly reduce inflammation and the immune response, which is crucial in reversing the rejection process.

High-dose steroids are effective, particularly for cellular rejection, because they have a direct impact on lymphocyte activity, which is a major component of the cellular rejection process. In patients experiencing moderate acute cellular rejection, this initial approach helps to stabilize the condition before additional therapies may be considered.

While thymoglobulin administration can also be part of the treatment regimen for severe acute rejection, it is typically reserved for cases where initial steroid therapy is ineffective or in cases of more severe rejection. Similarly, admitting for intravenous steroids could be a viable option, yet in many clinical settings, high-dose oral prednisone can be initiated on an outpatient basis if the rejection is moderate and the patient is stable. Increasing the dosage of mycophenolate mofetil does not have a direct effect on acute rejection in the immediate term, as it is usually used as a baseline immunosuppressive agent for long-term management rather than for treating acute