Diagnosing graft rejection in neonates involves a combination of clinical signs, laboratory tests, and imaging studies. Clinical signs may include poor feeding, fever, or graft dysfunction. Laboratory tests such as serum creatinine levels (for kidney transplants) or liver function tests (for liver transplants) are crucial. Imaging studies like ultrasound or MRI can help assess graft viability. Biopsy remains the gold standard for diagnosing rejection, providing histological evidence of immune-mediated damage.