A case of the successful kidney transplantation among two homozygous twins is presented here. Prior to the familial kidney transplantation from the identical twins, the patient underwent peritoneal and haemodialyses as well as cadaveric kidney transplant from an unrelated donor. In this patient, vascular accessibility was poor and the second familial transplantation was performed urgently. Transplanted kidney function proved excellent; however, the issues of the best immunosuppressant to be selected are under consideration. Decision on the use or withdrawal of immunosuppressant drugs requires careful review of the disease status, concomitant disease and other factors influencing the final outcome.