BACKGROUND: Improved short-erm kidney graft survival, focus has shifted towards long-term survival. The objective of the present study was to determine the clinical transplant variables possibly associated with long-term graft survival. METHODS: A retrospective study was conducted in 336 living donor kidney transplant recipients from August 1978 to August 2005. The results of the transplantation were analyzed according to the various factors known to influence the graft survival. RESULTS: The overall allograft survival rate was 76.9% at 5-years and 57.9% at 10 years. The 5- and 10-year graft survival rates in the recipients with cyclosporine medication were 76.9% and 61.1%, respectively. The corresponding rates of the recipients without cyclosporine medication were 60.4% and 35.5%, respectively. The graft survival rate was worse in recipients with old age donors (> or =50 yrs). The graft survival rate in the recipients with acute rejection was lower than that in the recipients without acute rejection (p<0.05). But, HLA compatability, diabetic history, pre-transplantation dialysis modality and dialysis duration had no effect on allograft survival. CONCLUSION: Acute rejection, without cyclosporine medication and old age donors are predictive factors for long-term graft survival.