Malheiro J, et al. - Both donor-specific antibodies (DSA) and anti-angiotensin II type 1 receptor antibodies (AT1R-abs) have been associated with poor graft outcomes after kidney transplantation (KT). Herein, the impact of pretransplant AT1R-abs with or without concomitant DSA on KT outcomes was studied. Findings demonstrated the association of acute rejection (AR) incidence and graft failure with both DSA and AT1R-abs. A proper negative impact of AT1R-abs on graft outcomes was shown, besides a synergistic one with DSA. Pretransplant AT1R-abs should be acknowledged to better stratify patients’ immunological risk.