AUTHOR=Owen Ruth , Kourounis Georgios , Karki Bishow , Connor Katie , Brown Charlotte , Kayani Kayani , Elzawahry Mohamed , Blanco Ruth , Schilirò Davide , Smith Paul , Mehew Jenny , Manook Miriam , Scuffell Carrie , Amer Aimen , Tingle Samuel , Thompson Emily R. ,  CRAFT Study Collaborators , Hackney Lauren , McGrogan Damian , Tohill Clara , McBride Shauna , Austin Isobel , Kayani Kayani , Dabare Dilan , Okafor Ugochukwu , Rashid Raja , Brown Poppy , Radnaeva Irena , Ghattas Tariq , Radwan Ahmed , Spiers Harry V. M. , Walker Catriona , Appleton Paula , Brown Charlie , Chalklin Christopher , Szabo Laszlo , Ahmad Farhan , Ahmad Hamza , Mentor Keno , Connor Katie L. , Thomas Rachel , Clark Karen , McKane Neil , Gupta Eksha , Pearson Robert , Aitken Emma , Alonso-Becerra Aldo , Weemes Jessica , Barlow Adam , Tasleem Sadia , Daga Sunil , Bautista Melissa , Azhar Amirh , Nita George , Goldsmith Petra , Jordan Caitlin , Phillips Benedict , Maple Hannah , Hussein Ahmed , Nikooiyan Yasaman , Jaradat Fayyad , Milovanovic Zoja , Matthews Rebecca , Hossain Mohammad Ayaz , McCaig Fiona , Blanderan Baven , Sweatman James , Seet Christopher , Khurram Muhammad , Lindsey Ben , Mohamed Ismail , Clementoni Laura , Owen Ruth , Khambalia Hussein , Greenwood-Morgan Malcom , Erum Orus , Thompson Emily , Amer Aimen , Scuffell Carrie , Yap Tzer En , Kissane Eleanor , Kenny Laura , Almoosawi Batool , Dobbins Joe , Tingle Sam , Nur Jenny , Kourounis George , Abdelbar Sarah , Sadik Hatem , El Shafei El Zawahry Mohamed Aly M. , Reddy Srikanth , Whitehead Thomas , Al-Karboolee Nasir , Khan Muhammad Sheharyar , Khan Faraaz , Mahendran Balaji , Hitchins Charlotte , Muneeswaran Sundar , Alzoubi Haitham , Boffa Catherine , Szentpali Abris , Karki Bishow Bekhyat , Marie Yazine , Halwa Ahmed 
  
TITLE=Multicentre Collaborative Prospective Cohort Study Investigating the Impact of Enhanced Recovery After Surgery on Kidney Transplant Outcomes: The CRAFT Study
  
JOURNAL=Transplant International
  
VOLUME=Volume 38 - 2025
  
YEAR=2026
  
URL=https://www.frontierspartnerships.org/journals/transplant-international/articles/10.3389/ti.2025.15541
  
DOI=10.3389/ti.2025.15541
  
ISSN=1432-2277
  
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.