Objectives: Various delays may occur from the point of opting for living-donor kidney transplantation (KT) as a definitive kidney replacement therapy to the point of the surgery. We aimed to describe factors affecting the time to transplantation at the university medical unit of the National hospital of Sri Lanka (NHSL). Methods: This was a retrospective study. Patients with an identified living-donor who had been registered for evaluation for transplantation between January 2017 and July 2021 were selected from the electronic database (Figure 1). Information on socio-demographics, time to transplantation (time between identification of a donor and surgery), perceived factors affecting time to transplantation, and outcomes were collected by telephone-interview. Results: One-hundred and eighty-two registered patients were identified, of whom 131 (72%) were recruited (Figure 1). Mean age was 46.4 years (SD + 13.3). Majority were males (n=96, 73.3%,). Eighty-eight (67.1%) had proceeded to KT, of whom 77 (87.5%) were alive at a median follow up of 111 weeks (Range 9-221). Median time to transplantation was 49 weeks (Range 3-161 weeks). For those who had not proceeded to transplantation, the median time on the waiting list was 93 weeks (Range 6-187). Fifteen (11.4%) had died before proceeding to KT. (Figure 2). Fifty-eight (62.5%) of those transplanted felt the process had been delayed. Of those reporting delay, withdrawal (n=14, 24.1%), acute illness (n=7, 12.1%), and co-morbidities (n=4, 6.9%) were reported as contributing donor-related factors; and cardiovascular diseases (n=7,12.1%) and acute illness (n=15, 25.9%) as contributing recipient-related factors. Delays in investigations of the donor (n=14, 24.1%), and the recipient (n=3, 5.2%), the COVID-19 pandemic (n=8, 13.8%), and logistic issues (n=8, 13.8%) were reported as institutional/situational factors contributing to the delay. Conclusions: Institutional delays in completing the investigations of recipient and donor and logistic issues around transplantation are remediable factors contributing to delays in KT in our unit.