Adolescents suffering from end-stage renal disease face the life-prolonging and, one hopes, the lifesaving procedures of hemodialysis and transplantation and the struggle to prevent rejection of the allograft. They also experience, according to their age and developmental stage, the psychophysiological thrust and the social demand of adolescence. Through the case histories of patients who had their kidney transplants almost three years ago, this paper attempts to demonstrate how four teenagers are handling their age-appropriate growth tasks. This case material derives from the cumulative observations of the renal transplant group, which includes a psychiatric team.