*Purpose: To compare the graft and patient survival of living and deceased donor kidney transplant and identify the factors that affect graft survival.

*Methods: Retrospective cohort study done in National Kidney and Transplant Institute from January 2013 to December 2017. Kaplan-Meier was used to determine graft and patient survival and logistic regression to establish correlation between factors and survival.

*Results: Among the 787 kidney transplants included, 154 were from deceased and 633 were from living donors. Incidence of delayed graft function was higher in deceased donor kidney transplant but the incidence of acute rejection was comparable between the two groups. Graft survival was higher in the living donor at 99.2% vs 91.5% at 6 months, 98.4% vs 89.6% at 1 year, 96.5% vs 88.3% in 2 years and 94.8% vs 87% in 3 years. Patient survival was higher in the living donor at 99.5% vs 92.2% at 6 months, 98.7% vs 90.9% at 1 year, 97.8% vs 90.3% in 2 years and 96.8% vs 89.6% in 3 years. Donor’s older age and female gender, incidence of delayed graft function, acute tubular necrosis and acute rejection adversely affect graft survival.

*Conclusions: Outcome of kidney transplant in this institution continued to improve, however graft survival and patient survival of deceased donor kidney transplant were lower. Factors that negatively affect graft survival were identified.

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