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Lookup NU author(s): Dr Ruth Owen, Dr George KourounisORCiD, Aimen Amer, Dr Sam Tingle, Dr Emily ThompsonORCiD
This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).
Copyright © 2026 Owen, Kourounis, Karki, Connor, Brown, Kayani, Elzawahry, Blanco, Schilirò, Smith, Mehew, Manook, Scuffell, Amer, Tingle, Thompson and CRAFT Study Collaborators. Perioperative complications are common in kidney transplantation. Enhanced recovery after surgery (ERAS) is a well-established multimodal perioperative care pathway designed to improve patient outcomes, however, its efficacy in renal transplant remains poorly described. Participating centres included adult renal transplant recipients and 30-day follow-up data. The primary outcome was LOS. Multivariable hierarchical models compared cohorts. 213 patients were included in the study period. 18/23 UK kidney transplant centres were represented. Analysis of the perioperative care delivery demonstrated similar patterns irrespective of reported protocols, with a tendency towards ERAS-type care. Between cohorts, the incidence of complications were similar; formal ERAS 14.3%, ERAS informal 17.0%, no ERAS 12.6%; p = 0.64. Median LOS was also similar; formal ERAS 6.0 days (5.0-11.5), informal ERAS 7.0 days (5.0-10.5) vs. no ERAS 6.0 days (5.0-10.5); p = 0.75. Readmissions were comparable; p = 0.721. Multivariable models confirmed these findings and demonstrated frailer patients had longer LOS and more readmissions. Currently, most UK renal transplant centres deliver a form of peri-operative ERAS care, indicating broad adoption of ERAS principles. Consequently, a formal ERAS protocol is not associated with decreased complications, LOS or readmissions. Efforts to improve outcomes should focus on prehabilitation of at-risk groups on the waiting list.
Author(s): Owen R, Kourounis G, Karki B, Connor K, Brown C, Kayani K, Elzawahry M, Blanco R, Schiliro D, Smith P, Mehew J, Manook M, Scuffell C, Amer A, Tingle S, Thompson ER
Publication type: Article
Publication status: Published
Journal: Transplant International
Year: 2025
Volume: 38
Online publication date: 14/01/2026
Acceptance date: 12/12/2025
Date deposited: 16/02/2026
ISSN (print): 0934-0874
ISSN (electronic): 1432-2277
Publisher: Frontiers Media SA
URL: https://doi.org/10.3389/ti.2025.15541
DOI: 10.3389/ti.2025.15541
Data Access Statement: Anonymized raw data supporting the conclusions of this article will be made available on reasonable request.
PubMed id: 41613396
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