Introduction: Intellectual dysability (ID) has been a controversial relative contraindication to organ transplantation. Despite the strong ethical obligation to provide the best of care for this vulnerable group of patients, many centers still hesitate to offer the possibility of kidney transplantation. Currently, there are few data available in the literature that describe the outcome of kidney transplantation in patients with ID. 
Methods: We retrospectively studied adult kidney transplant recipients in organ transplant center in Croatia.Posttransplant complications were recorded. We also interviewed the family members or caregivers during their scheduled outpatient visit asking questions about improved quality of life.
Results: Among 2500 kidney transplant recipients who received kidney allograft at the Clinical hospital center Zagreb, 22 patients had IDD. Twenty patients have parental supervision while two live in an institution with professional help.
The mean age at transplantation was 28.6 years (12 to 43 years). Twenty patients received kidney allografts from a deceased donor and two from a living donor. One patient was preemptively transplanted, and others received their kidney allograft after a mean of 4.7 years (1-17 years) of dialysis. Two patients developed posttransplant lymphocele, one new-onset diabetes after transplantation, and one had acute T-cell-mediated rejection. The most pronounced problem was weight gain, while four patients almost doubled their original weight after the transplantation. Five-year graft and patient survival was 100 %. 
Most importantly, all patients with IDD were evaluated for kidney transplantation, and none were rejected because of their intellectual disability.
Conclusion: Patients should not be discriminated against because of their ID. With appropriate support from the transplant team and their caregivers, outcomes after transplantation in patients with ID are excellent with outstanding compliance. Finally, kidney transplantation significantly improved the quality of life not only of recipients, but also of their caregivers, and the whole family.