INTRODUCTION: Situs inversus totalis (SIT) represents a total vertical 
transposition of the thoracic and abdominal organs which are arranged in a 
mirror image reversal of the normal positioning. We presented a successful 
pre-dialysis kidney transplantation from a living sibling donor with SIT and the 
longest donor follow-up period, along with analysis of the reviewed literature.
CASE REPORT: The pair for pre-dialysis kidney transplantation included a 
68-year-old mother and 34-year-old daughter at low immunological risk. Comorbid- 
ities evidenced in kidney donors with previously diagnosed SIT, included 
moderate arterial hypertension and borderline blood glucose level. Explantation 
of the left donor kidney and its placement into the right iliac fossa of the 
recipient were performed in the course of the surgical procedure. A month after 
nephrectomy, second degree renal failure was noticed in the donor. A 20-month 
follow-up of the donor's kidney and graft in the recipient proved that their 
functions were excellent.
CONCLUSION: In donors with previously di- agnosed SIT the multidisciplinary 
approach, preoperative evaluation of the patient and detection of possible 
vascular anomalies are required to provide maximum safety for the donor.