Clayton PA, et al. - Researchers analyzed data from the Australia and New Zealand Dialysis and Transplant (ANZDATA) Registry between 1997 and 2017 for the association of acute rejection (AR) within 6 months of kidney transplant with long-term outcomes of transplant recipients. Among 13,614 included recipients of a primary kidney-only transplant, 2906 recipients (21.4%) experienced AR. Recipients with early AR more frequently had graft loss attributable to chronic allograft nephropathy and recurrent AR. In addition, recipients with early AR showed a higher likelihood of dying from cardiovascular disease or cancer. Hence in kidney transplantation, AR remains a relevant short-term outcome with notable long-term effects.