In general, you want to stay with the HIG (Human Interface Guidelines) as much as possible:
http://developer.apple.com/iphone/library/documentation/userexperience/conceptual/mobilehig/Introduction/Introduction.html
This will maintain a consistant look and feel of applications between all apps on the iphone. This does not mean that all apps have to LOOK the same, but the closer you stay to within the HIG, the better off you will be and the better received your application will be. Typically. However, Apple does not make objects for every condition so it is required to create your own look when no other metaphor exists within Apple's frameworks.
As for subclassing Apple objects, like UITableViewCellAccessory, there are no rules against that.
Then there is who reviews the App. I really believe there is a luck to the draw on who the reviewer is assigned to the app.
More specifics might help get a more concrete answer.