Objectives: African American (AA) kidney transplant recipients experience disproportionately high rates of graft loss. The aim of this analysis was toestablish and quantify the impact of the overall graft loss and patient death on the disparity in U.S. AA kidney transplant outcomes using an OrganProcurement and Transplantation Network (OPTN)/United Network for Organ Sharing (UNOS) data set that contains detailed baseline andlongitudinal clinical data. Methods: We performed a longitudinal cohort study of kidney transplant recipients using a data set created by UNOS, including 266,128 (70,215AA, 195,913 non-AA) transplant patients enrolled between 1987 and December 2016. Multivariable analysis was conducted using 2-stage jointmodeling of random and fixed effects of longitudinal data (linear mixed model) with time-to-event outcomes (Cox regression). Results: A total of 195,913 non-AA recipients (73.6%) were compared to 70,215 AA (26.4%) recipients. The 10-year-graft survival of AAs in all eraswas lower than that of non-AAs (31% in deceased kidney transplants (DKT) AA recipients vs. 42% in living kidney transplantation (LKT) non-AArecipients). The 10-year-patient survival of AAs with functioning grafts in all eras was similar to that of non-AAs. Multivariate Cox regression offactors associated with patient survival with functioning grafts included acute rejection within 6 months, diabetes mellitus, and hypertension. Atrend in pre-transplant recipient body mass index acting as a protective factor in patient survival of AAs with functioning grafts was noted, althoughit was not statistically significant. Conclusions: AA kidney transplant recipients with functioning grafts experience a substantial disparity in graft loss but not death.