Results of renal transplantation are better than those of dialysis. The indications of transplantation are constantly increasing and comprise more and more populations at risk, notably older patients and diabetics. Specific evaluation of such potential recipients can lead to indication for transplantation and registry on the waiting list. The insufficient number of available cadaver kidneys leads to harvesting borderline organs particularly from the elderly or patients with vascular disease. Before definite decision for transplantation is made, case-by-case evaluation has to be made of the potential risks of donor-recipient matching regarding the risk/benefit for the recipient. Only a significant increase in the number of available organs will relieve the constraints of the problem.