 Acute renal dysfunction post lung transplant is one of the morbidities encountered that will impact the outcome and costs of both hospitalisation and community care. This is a retrospective study analysing 51 cases of sequential bilateral lung transplant over the last 3 years. As primary variables we analysed pre and post-operative eGFR, ischaemic time, bypass time, intra/post-operative blood products, inotropic support peri - operatively, CVVH required, haemodialysis on discharge, duration of postoperative ventilation, length of stay in intensive care unit, return to theatre. Secondary variables analysed were bilateral lung transplant, and comorbidities. There were 29 patients who developed post-operative renal impairment, (57%) out of which 18 patients required CVVH within the first week of ITU stay. Out of these patients, there were 7 patients who were discharge to the ward on haemodialysis. Out of the 29 patients who developed post-operative renal impairment (eGFR<60), only 4 patient had pre-operative renal impairment (eGFR <60). Out of the 7 patients discharged to the ward on dialysis, 6 patients required post-operative inotropes, only one pre-operative inotropes and 6 patients required intra-operative blood products. 18 patients requiring CVVH post-transplant had a median bypass time of 300 mins and an ischaemic time of 350 mins. Out of the 18 CVVH patients, 17 patients required blood transfusion intra-operatively and 15 patients post-operatively. Out of the CVVH patients 15 patients had a prolonged ventilation (>1 day). A prolonged ischaemic time, as well as a prolonged operative time, mainly due to bilateral lung transplantation, as well as usage of blood products intra-operatively and inotropic support post operatively seems to be associated with a high incidence of renal impairment post sequential bilateral lung transplantation.