Primarysclerosingcholangitis(PSC)isachronicprogressiveinflammatorydiseaseaffectingthebileducts,leadingtofibrosisandeventuallycirrhosisinmostpatients.Itsetiologyisunknownandsofarnoeffectivemedicaltherapyisavailable.Livertransplantation(LTX)istheonlycurativetreatmentandatpresentPSCisthemainindicationforLTXintheScandinaviancountries.ClosetohalfofthePSCpatientsexperienceoneormoreepisodesofacutecellularrejection(ACR)followingtransplantationandapproximately1/5ofthetransplantedpatientsdeveloprecurrentdiseaseinthegraft.Inaddition,somereportsindicatethatACRearlyafterLTXforPSCcaninfluencetheriskforrecurrentdisease.Fortheseimportantpost-transplantationentitiesaffectingPSCpatients,wehavereviewedthecurrentliteratureonepidemiology,pathogenesis,treatmentandthepossibleinfluenceofrejectionontheriskofrecurrentdiseaseintheallograft.