BACKGROUND: As elsewhere, the growing organ shortage is a main problemfor organ transplantation. To solve the problem, we started accepting genetically unrelated, but emotionallyrelated living donors. METHODS: In the period of 1998-2002, 14 LERT are performed in the University ClinicalCentre in Skopje, Republic of Macedonia. As suitable donors are used predominantly spouses, but alsomother and brother in law. The immunosuppression included a quadruple protocol with Interleukin-2R antagonists,late cyclosporin A, MMF and steroids. The two-year graft and patients survival of LERT was compared with22 living genetically related donor transplantation (LRT) performed in the same time. RESULTS: The twoyears graft survival was 100% in LERT and 92% in LRT. There are not any significant difference amongthe medical and surgical complications between the two groups of pts. The actual serum creatinin was101+22 in LERT compared with 142+34 in LRT. CONCLUSION: The authors recommend the LERT as a valid alternativeespecially in the countries where the regular cadaver transplantation is not yet established.