Background: Enhanced recovery after surgery (ERAS) protocols have been applied widely in general surgery. It can decrease the length of hospital stay, increase patient satisfaction and reduce complications. However, research about ERAS in kidney transplantation is rare. Methods. In this single-center retrospective case series, we compare the outcomes of the first 159 kidney donors enrolled in our ERAS protocols to those 315 patients treated before implementation of the protocol. Highlights of the ERAS protocols include abolition of bowel reparation, preoperative carbohydrate loading, early regular diet and multimodal approach to opioid-sparing pain control. Results. After ERAS protocols initiation, median length of hospital decreased 1.3 days in living-donor kidney transplant recipients (10.1 vs 11.4 days, P=0.016) and 3.9 days in deceased-donor kidney transplant recipients (12.8 vs 16.7 days, P=0.008). The incidence of diarrhea decreased about 70% (5.7% vs 20.7%, P<0.001). Other complication rate remained similar such as biopsy-proven acute rejection (1.9% vs 5.7%, P=0.061), DGF (9.4% vs 11.7%, P=0.534), new-onset diabetes mellitus after transplantation(5.7% vs 8.3%, P=0.356) and Unplanned readmissions (7.6% vs 19.0%, P=0.803).
Conclusion:ERAS protocol for patients undergoing kidney transplantation surgery was associated with reduced length of hospital stay and decreased incidence of diarrhea. This study suggests that ERAS is feasible in kidney transplantation surgery.