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considered statistically significant. The statistical package SPSS V 25 and GraphPad Prism were used.RESULTS: Arterial anastomosis time was below the alarm/alert line in 93.3%/88.9% of RAKTs, while venous anastomosis time was below the alarm/alert line in 88.9%/73.9%. The non-anastomotic rewarming time (RWT) exceeded þ3SD in 24.7% of procedures and þ2SD in 37.1%. In only 46% cases was the RWT below the alert line. The ureterocystoneostomy time was below þ2 and þ3SD in 87.9% and 90.2% of cases, respectively. CUSUM showed that the learning curve for arterial anastomosis required up to 35 (mean[16) cases. Complications and delayed graft function rates decreased significantly and reached a plateau after the first 20 cases. A similar conclusion was reached for venous anastomosis, which may need more than 40 procedures (mean [24). The plateau in the ureterocystoneostomy curve was reached within 30 RAKTs in 4/5 centers (mean[17). The plateau for RWT was reached within 23 procedures at center 1, 44 at center 2, and 38 at center 3 (mean 35 cases); centers 4 and 5 did not reach the plateau. Interestingly, the curves for non-anastomotic time during RWT resemble those for RWT. On the linear regression model, all the anastomotic times were comparable. The slopes in respect of non-anastomotic time during RWT were slightly different (p[0.0006), as was also true for RWT itself (p[0.007).CONCLUSIONS: A minimum of 35 cases is necessary to reach reproducibility in terms of anastomosis time, rewarming time and functional results.