Kidney transplantation has become the treatment of choice for end-stage renal disease. However, its application is limited due to inadequate organ supply, mainly because many dialysis patients do not have suitable living donors. The increasing, discrepancy between organ supply and demand has forced many transplant centers to consider using organs procured from marginal donors. The aim of this study was to investigate whether utilization of kidneys from living related elderly donors is safe for the recipients in the long term. We analyzed the clinical results of 296 consecutive recipients of living related renal transplants, among whom 44 recipients received kidneys from donors over 60 years of age. By the end of 12 months, the mean serum creatinine level of the recipients who were transplanted from the older donors was higher (1.55 +/- 0.45 mg/dL) than that from other donors (1.21 +/- 0.3 mg/dL), but the difference was not significant (P = .08). In the long term (60 months), the graft function was similar (1.88 +/- 0.55 vs 1.52 +/- 0.38) for both groups. The similarity in outcomes of ideal versus older donors as shown less in the present series has encouraged us to utilize elderly living donors. We concluded that transplantations performed from the elderly donors yielded similar results to those of conventional donors. The long waiting list for transplantation, the treatment of choice for end-stage renal disease, should encourage us to be more flexible about donor selection.