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Based on experiences with 256 kidney transplant operations in 239 patients over a period of ten years (18.6. 1965 to 15.4. 1975) the role of the anaesthesiologist as it had developed in our institution has been described. Some problems with regard to the anaesthetic management of living donors were discussed. The care of patients who, due to their deteriorating cerebral function, are potential donors was also described. An outline of the own anaesthetic management of the recipient has been given and alternative methods were mentioned. Some special points were specifically stressed like the choice of relaxants, fluid replacement, blood transfusion, diuretic treatment starting already intraoperatively. Good intensive care of the potential donor is of great importance for the function of the transplanted organ. Very important is also the postoperative treatment of the recipient, which in our institution is performed in a teamwork between anaesthesiologist, surgeon and nephrologist. Finally, the functional results of our series are briefly demonstrated.