Logo Annals of Transplantation Logo Annals of Transplantation Logo Annals of Transplantation

10 April 2018 : Original article  

Low Mean Arterial Blood Pressure is Independently Associated with Postoperative Acute Kidney Injury After Living Donor Liver Transplantation: A Propensity Score Weighing Analysis

Hye-Mee Kwon1E, Young-Jin Moon1A*, Kyeo-Woon Jung2B, Hye-Won Jeong2B, Yong-Seok Park2B, In-Gu Jun1DEF, Jun-Gol Song1DEF, Gyu-Sam Hwang1ADE

DOI: 10.12659/AOT.908329

Ann Transplant 2018; 23:236-245


BACKGROUND: As end-stage liver disease progresses, renal blood flow linearly correlates with mean arterial blood pressure (MBP) due to impaired autoregulation. We investigated whether the lower degree of postoperative MBP would predict the occurrence of postoperative acute kidney injury (AKI) after liver transplantation.

MATERIAL AND METHODS: This retrospective study enrolled 1,136 recipients with normal preoperative kidney function. Patients were categorized into two groups according to the averaged postoperative MBP: <90 mmHg (MBPbelow90) and ≥90 mmHg (MBPover90). The primary endpoint was occurrence of postoperative AKI, defined by the creatinine criteria of the Kidney Disease Improving Global Outcomes. The logistic regression model with inverse probability treatment weighting (IPTW) of propensity score was used to compare the risk of postoperative AKI between two groups.

RESULTS: MBPbelow90 group (83.0±5.1 mmHg) showed higher prevalence and risk of postoperative AKI (74.2% versus 62.6%, p<0.001; IPTW-OR 1.34 [1.12–1.61], p=0.001) compared with MBPover90 group (97.3±5.2 mmHg). When stratified by quartiles of baseline cystatin C glomerular filtration ratio (GFR), the association between MBPbelow90 and postoperative AKI remained significant only with the lowest quartile (cystatin C GFR ≤85 mL/min/1.73 m²; IPTW-OR 2.24 [1.53–3.28], p<0.001), but not with 2nd–4th quartiles.

CONCLUSIONS: Our results suggest that maintaining supranormal MBP over 90 mmHg may be beneficial to reduce the risk of post-LT AKI, especially for liver transplant recipients with cystatin C GFR ≤85 mL/min/1.73 m².

Keywords: arterial pressure, Liver Transplantation, Renal Circulation

Add Comment 0 Comments

918 3

In Press

06 Jun 2023 : Original article  

A 15-Year Retrospective Study of Supportive Extracorporeal Therapies Including Plasma Exchange and Continuo...

Ann Transplant In Press; DOI: 10.12659/AOT.939745  

02 Jun 2023 : Original article  

Survival analysis of transplant-associated thrombotic microangiopathy under different diagnostic criteria a...

Ann Transplant In Press; DOI: 10.12659/AOT.939890  

10 May 2023 : Original article  

Incidence of Thromboembolic Complications Following Kidney Transplantation with Short and Extended Aspirin ...

Ann Transplant In Press; DOI: 10.12659/AOT.939143  

Most Viewed Current Articles

24 Aug 2021 : Review article  

Normothermic Machine Perfusion (NMP) of the Liver – Current Status and Future Perspectives

DOI :10.12659/AOT.931664

Ann Transplant 2021; 26:e931664

26 Jan 2022 : Review article  

Recurrence of Hepatocellular Carcinoma After Liver Transplantation: Risk Factors and Predictive Models

DOI :10.12659/AOT.934924

Ann Transplant 2022; 27:e934924

29 Dec 2021 : Original article  

Efficacy and Safety of Tacrolimus-Based Maintenance Regimens in De Novo Kidney Transplant Recipients: A Sys...

DOI :10.12659/AOT.933588

Ann Transplant 2021; 26:e933588

15 Mar 2022 : Case report  

Combined Liver, Pancreas-Duodenum, and Kidney Transplantation for Patients with Hepatitis B Cirrhosis, Urem...

DOI :10.12659/AOT.935860

Ann Transplant 2022; 27:e935860

Your Privacy

We use cookies to ensure the functionality of our website, to personalize content and advertising, to provide social media features, and to analyze our traffic. If you allow us to do so, we also inform our social media, advertising and analysis partners about your use of our website, You can decise for yourself which categories you you want to deny or allow. Please note that based on your settings not all functionalities of the site are available. View our privacy policy.

Annals of Transplantation eISSN: 2329-0358
Annals of Transplantation eISSN: 2329-0358