283 Creating an ERAS for Living Donors for Renal Transplant

Abstract

Abstract Aim To design and facilitate an enhanced recovery after surgery (ERAS) protocol for the Wessex Kidney Centre (WKC) for live donors for renal transplants. This audit focussed on the post-operative analgesia guidelines and average length of hospital stay post the ERAS protocol implementation. Method An enhanced recovery after surgery (ERAS) protocol was created for renal living donors. The protocol incorporated pre, peri and post-operative guidelines to optimise patient care. The protocol was based on a survey sent to all transplant units in the UK regarding their own pathways for live donors(13/23 units responded). The ERAS protocol was then trialled on all live donors throughout 2020 and into 2021 at WKC. For this audit, data was collected on length of stay, analgesia used post-operatively and the VAS scores recorded by patients to grade their pain levels. Results There were a total of 11 renal live donors from September 2020 to January 2021 during which data was collected on all donors. National average length of stay for live donors is 3.9 days. Post ERAS, the average length of stay at WKC is 2.1 days, reduced from an average of 6 days pre-protocol. There was a minimal change in VAS score at 6 hours post-operatively: 3.9 (pre-ERAS average 4.2). However, at 24 hours post-operatively, average VAS score was 2.6 (pre-ERAS average 3.7). Conclusions The introduction of a specific ERAS protocol for live donors for renal transplant notably improved the average post-operative pain scores and reduced the average length of stay to below the national average.