1014 Aim: Acute cellular rejection following liver transplantation is common but there is no reliable indicator pretransplant which allows tailoring of immunosuppression. Contact sensitisation to a neo-antigen pretransplant was carried in patients with chronic liver disease to assess its ability to predict acute cellular rejection following transplantation. Method: Patients on the waiting list for transplantation were sensitised to diphenylcyclopropenone (DPC)for 48 hours. An elicitation test was carried out 14 days later and a score given for each of the 5 concentrations tested (bulla = 3, vesicles =2, erythema = 1). Acute cellular rejection was defined as rejection requiring therapy with high dose steroids. The clinicians deciding on therapy were blinded to skin test results as were the pathologists. The histopathological score was also noted in those who had biopsies at day 7. The nutritional status, aetiology and Child's score was also assessed. Results: 41 patients (17 PBC,10 ALD,5 PSC,4 HBV,2 cryptogenic,2 AIH,1 HCV) have been tested. Twenty two had no response while the 19 responders had skin test scores from 1-9. Three patients, all non-responders, died on the waiting list. Eighteen of 19 non-responders did not have acute rejection while 14 of 19 responders required treatment for acute rejection (p<0.001). The histological grading of rejection according to the Banff criteria in the various skin test scores is shown below (6 non-responders had no biopsy). (Table)TableConclusions: The ability to mount a contact sensitisation response to a neoantigan pretransplant predicts those patients who will not require treatment for acute cellular rejection. There is a relationship between the magnitude of response and the severity of acute cellular rejection. This may allow tailoring of immunosuppression on an individual basis. This research was funded in part by Fujisawa Ltd.