Objective To increase the awareness of the successful use of horseshoe
kidneys in renal transplantation. Patients and methods Two donors wer
e found to have horseshoe kidneys; these were divided at the midline a
nd transplanted into four recipients. Results All four recipients had
a delayed return of renal function; all eventually functioned with no
complications related to the horseshoe kidney. Conclusion Transplantat
ion of horseshoe kidneys has been performed infrequently but they shou
ld be considered as suitable for transplants, considering the shortage
of cadaver donors and, when possible, should be divided at the isthmu
s and the halves transplanted into two recipients.