*Purpose: The new kidney allocation system went into effect in the middle of March 2021. The consequences of this new system affected transplant centers differently, mainly based on their geographical location. We aimed to study the effect of the new allocation system on the transplant outcomes in a single institution.

*Methods: We retrospectively reviewed patients who underwent kidney transplantation only from 8/15/2020 to 10/15/2021. The mean follow up was 5.2 months (IQR: 3.8-5.9). We excluded patients who had a living donor and those who received deceased dual organ transplantation. Patients were divided in to 2 groups. Group 1 (n=103) included patients from 8/15/2020 to 3/14/2021 while group 2 (n=136) included patients form 3/15/2021 to 10/15/2021.

*Results: There was no difference in patients demographics between both groups (see table). The mean donor KDPI was similar between both groups (p=0.77). There was a higher incidence of DCD kidneys in group 2 (54% vs 31%, p<0.0001). The mean cold ischemia time (704 minutes vs 448 minutes, p <0.00001) and warm ischemia time (12 minutes vs 7 minutes, p=0.006) was higher in group 2. There was no difference in length of hospital stay (p=0.27), Delayed graft function (p=0.56), creatinine at discharge (p=0.13), creatinine at last follow up (p=0.29) post-operative complications (p=0.67) and readmission rate in the first 90 days between both groups. The graft survival rate was 97% in group 1 and 100% in group 2 (p=0.14).

*Conclusions: The new allocation system was associated with more cold ischemia time, warm ischemia time and DCD kidney transplantation. However this did not have an effect on the short term kidney transplantation outcomes in our institution. More follow up is needed to observe if this trend will change in the future and if those findings will affect the long term outcomes.

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