Multicentre Collaborative Prospective Cohort Study Investigating the Impact of Enhanced Recovery After Surgery on Kidney Transplant Outcomes: The CRAFT Study.
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All Authors
Owen, R.
Kourounis, G.
Karki, B.
Connor, K.
Brown, C.
Kayani, K.
Elzawahry, M.
Blanco, R.
Schiliro, D.
Smith, P.
LTHT Author
Blanco Colino, Ruth
LTHT Department
Abdominal Medicine & Surgery
Hepatobiliary Surgery
Transplant Surgery
Hepatobiliary Surgery
Transplant Surgery
Non Medic
Publication Date
2025
Item Type
Journal Article
Multicenter Study
Multicenter Study
Language
Subject
ENHANCED RECOVERY AFTER SURGERY , UNITED KINGDOM , KIDNEY TRANSPLANTATION
Subject Headings
Abstract
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. Copyright © 2026 Owen, Kourounis, Karki, Connor, Brown, Kayani, Elzawahry, Blanco, Schiliro, Smith, Mehew, Manook, Scuffell, Amer, Tingle, Thompson and CRAFT Study Collaborators.
Journal
Transplant International