Living-donor transplantation has several obvious advantages for children: better graft-survival than cadaveric-transplantation, the possibility to be pre-emptive and avoid dialysis and its burden to the child, to be programmed during school holidays. However, its negative aspects must not be ignored. They are mainly psychological and concern the adolescent. The affective burden of both living-donation and transplantation is so strong that a psychological check-up is mandatory for the donor but also for the recipient and even the non-donor parent. In the medical evaluation of the donor, specific explorations, such as the search of a genetic mutation, could be necessary in the case of hereditary renal disease. (C) 2007 Elsevier Masson SAS et Association Societe de Nephrologie. Tous droits reserves.