Objective: To increase the awareness of the successful use of horseshoe kidneys in renal transplantation.
Patients and methods: Two donors were found to have horseshoe kidneys; these were divided at the midline and 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: Transplantation of horseshoe kidneys has been performed infrequently but they should be considered as suitable for transplants, considering the shortage of cadaver donors and, when possible, should be divided at the isthmus and the halves transplanted into two recipients.