Outcome following renal transplantation is influenced by several interdependent factors. This study was designed to test the hypothesis that graft outcome can be enhanced by close follow-up thus increased compliance of patients. The aim is to assess graft survival of patients enrolled in post-transplant studies (high compliance group) versus control group not enrolled in any post-transplant studies (low compliance group). Patients enrolled in studies had more aggressive follow-up then non-study patients. From January 1996 to Decembre 2002, we performed 1718 renal transplants. Patients were enrolled in 20+ post-transplant Phase II and III clinical trial studies (high-compliance group) at 23% (n = 389) of our transplanted population and were compared to control group of 77% (n=1328) patients not enrolled in any post-transplant studies. ANOVA, T-Test and Kaplan Meier were used for analyses. Demographic profile of high compliance group not significantly different from control group in all categories except mean CIT. In contrast, graft survival of the high compliance group (89% /1 yr, 73% /5 yrs) was significantly better than control group (88% /1 yr, 63% /5 yrs) (p=0.04). One and 5 yrs. patient survival in study group was 90%, 80% respectively vs. 95%, 78% in control (p=0.68). Since donor and recipient profile of each group was similar, difference in graft outcome can be attributed to a higher level of compliance by patients enrolled in post-transplant studies versus those that were not. As patient follow-up includes many factors in addition to immunosuppressive therapy, results suggest improved graft outcome may not be based exclusively on immunosuppressive therapy. Further studies should be performed to determine what aspects of compliance have a direct effect on graft survival. Furthermore, our study shows that close follow-up of patients following transplantation is a determining factor that can help prolong the survival of renal grafts by up to 10%.