The application of kidney from expanded criteria donor(ECD) increases year by year because of a severe shortage of donor kidneys.The clinical effect of kidneys from ECD is not as good as those of standard criteria donor kidney transplantation and more complications were found after transplantation. So the ethical principles of safe and effective, and informed consent need to be strictly followed. Firstly, There is no uniform criterion for the evaluation of ECD around the world at present. So it is necessary for the ethics committee to adopt reasonable means to fully examine, avoiding to the abuse of kidneys from ECD and serious damage to the recipient′s economy, health and even life safety. Secondly, informed consent of recipients should be obtained for ECD donor kidney transplantation, but they are very likely to refuse to recieve transplantation after they know that, which eventually lead to the application of donor organs from ECD unable to be carried out. It is suggested that the health administrative department and the branch of organ transplantation of Chinese Medical Association should cooperation with each other to draw up an authoritative and credible informed consent letter containing the relevant contents of ECD donor kidney transplantation for unified use in transplantation centers. Informed notification should be given when uremic patients first visit the transplantation centers for their free and full informed consent.