Background: The incidence of horseshoe kidneys is between 1 in 300 and 1 in 1600. Horseshoe kidneys may be either transplanted into two recipients after division of the kidney, or used for en bloc transplantation into one recipient.
Methods: We report two cases of adult-to-child and child-to-adult transplantation of horseshoe kidneys. Embryology and associated abnormalities are outlined, and previous case reports reviewed.
Results: One transplant was successful and one transplant failed due to an unrecognized C peptide deficiency.
Conclusions: Horseshoe kidneys are acceptable as donor organs in renal transplantation.