Two cases of suicide by related kidney donors following graft rejection and the death of the recipients are reported. It is concluded that psychiatric screening of the donor before transplantation is necessary in order to obtain information about past psychopathology, ambivalence involved in donating the kidney, psychological style, characteristic defenses and behavioral repertoire used to cope with anxiety and disappointed life circumstances. The data are necessary to assess the donor’s capability of accepting a possible failure of the transplantation procedure. A psychiatric evaluation after transplantation is indicated following graft rejection and death of the recipient to assess the development of depression and suicidal potential of the related donor.