Aim of this monocentric study is to compare the outcome of 101 renal transplants performed in patients older than 55 years with single kidney retrieved from donors older than 50 years, with 263 transplants performed in patients younger than 55 years transplanted with young kidneys. Delayed graft function (DGF) had similar incidence (24 vs 23%). Acute rejections (AR) were fewer in younger recipients without statistical significance. A 6-month serum creatinine < 130 mmol/L was less frequent in older recipients (RR 1.20; p=0.004). 5-year patient survival rate was lower in older patients (80.6% vs 92.6%; p=0.009). Crude 5-year graft survival rate was lower in older recipients (68.5% vs 84.5%; p=0.004). Adjusting for death with functioning kidney 5-year graft survival was still, but not significantly, lower in older recipients (82.8% vs 90%; p=NS). This data outline that graft survival rate must be always adjusted for death with functioning grafts and that excellent outcomes with a 5-year graft survival, higher that 80% can be obtained in old patients using single cadaveric kidneys.