*Purpose: Early recovery after surgery protocols (ERAS) has been adopted in many surgical procedures. In 2018 we introduced transplant ERAS to our institution. It included modified preoperative counselling, strict fluid replacement, earlier discharge, outpatient dosing of induction immunosuppression and intensified postoperative follow-up.

*Methods: We retrospectively reviewed 817 patients who had kidney transplantation only in our department from 2015 to 2020 with at least 6 months follow-up. Patients were divided into 2 groups; Group 1 from 2015 to 2017 (n=369) and Group 2 from 2018 to 2020 (n=448)

*Results: Patients in Group 2 were older (56 vs 53 years, p<0.01) and had fewer living donation (32.3% vs 44.6%, P<0.01). They had a lower rate of delayed graft function (DGF) (8% vs 16.8%, P<0.01), decreased length of stay (3 vs 5 days, P<0.01) with a higher creatinine level at discharge (3 vs 2 mg/dl, P<0.01) but similar creatinine levels (p=0.1) and better graft survival (99.3% vs 96.5%, P<0.01) at 6 months follow up.

*Conclusions: Our ERAS protocol was associated with a lower rate of DGF, decreased length of hospital stay, and better graft survival at 6 months. The higher creatinine at discharge can be explained by the lower percentage of living donation as well as the earlier discharge.

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