Kidney transplantation increases life expectancy in dialysis patients. However, shortage of organs is still a big problem. Advances in immunosuppresive therapy during the past two decades have led to substantial improvements in the outcome of living donor transplantaions. The impact of HLA matching on the graft survival in living donors is controversial. Opelz reported that HLA matching should be very important in living donor transplantation based on the results of the ''Colleberative Transplant Study (CTS) '' whereas UNOS data suggested that the unrelated donors transplants exhibited high greft and patient survival rates despite poor HLA matching. Since 22.11.2001 spousal kidney transplantation (tx) was performed for 35 patients in our center. HLA mismatches were:1 (2 patients), 2 (2 patients), 3 (5 patients), 4 (11 patients), 5 (10 patients) ve 6 (5patients). No graft or patient losses have been observed in the spousa donor programme. Since 17.5.2001 one HLA-match kidney tx programme has been begun. Only one patient was lost. Three-year graft and survival rates are 96%. The results of kidney tx from living-related donors with total HLA-mismatch since 2003 are presented in the table. No graft or patient losses have beeen observed. The immunosuppression types and doses are not different from the HLA-match tx. Our results seem to correlate with the Unos DATA. The greft and patient survival rate of 35 patients with spousal donors is 100% in Akdeniz University. The number of the patients with 5-mismatch donors in our center is 23%; three-year graft and patient survival rate is 96%. As a conclusion; considering the presence of long-waiting time on the list, poor HLA matching can be ignored in living donor transplantation under certain ethical, legal and scientific regulations.