Evidence map›Paper›PMID 39419173›Full record

ArticleBrazilian journal of anesthesiology (Elsevier)

Intraoperative hypotension during critical phases of liver transplantation and its impact on acute kidney injury: a retrospective cohort study.

Matthanja Bieze, Amir Zabida, Eduarda Schutz Martinelli, Rebecca Caragata, Stella Wang, Jo Carroll, Markus Selzner, Stuart A McCluskey

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Brazilian journal of anesthesiology (Elsevier). The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Matthanja BiezeToronto General Hospital, Department of Anesthesia and Pain Management, Toronto, Ontario, Canada; University of Toronto, Temerty Faculty of Medicine, Department of Anesthesiology and Pain Medicine, Toronto, Ontario, Canada. Electronic address: matth.bieze@gmail.com.
Amir ZabidaToronto General Hospital, Department of Anesthesia and Pain Management, Toronto, Ontario, Canada; University of Toronto, Temerty Faculty of Medicine, Department of Anesthesiology and Pain Medicine, Toronto, Ontario, Canada.
Eduarda Schutz MartinelliToronto General Hospital, Department of Anesthesia and Pain Management, Toronto, Ontario, Canada; University of Toronto, Temerty Faculty of Medicine, Department of Anesthesiology and Pain Medicine, Toronto, Ontario, Canada.
Rebecca CaragataAustin Health, Department of Anesthesia, Melbourne, Australia; University of Melbourne, School of Medicine, Department of Critical Care, Melbourne, Australia.
Stella WangUniversity Health Network, Department of Biostatistics, Toronto, Ontario, Canada.
Jo CarrollToronto General Hospital, Department of Anesthesia and Pain Management, Toronto, Ontario, Canada; University of Toronto, Temerty Faculty of Medicine, Department of Anesthesiology and Pain Medicine, Toronto, Ontario, Canada.
Markus SelznerTemerty Faculty of Medicine, Toronto General Hospital, Department of Surgery, and the Multi-Organ Transplant Program, Toronto, Ontario, Canada.
Stuart A McCluskeyToronto General Hospital, Department of Anesthesia and Pain Management, Toronto, Ontario, Canada; University of Toronto, Temerty Faculty of Medicine, Department of Anesthesiology and Pain Medicine, Toronto, Ontario, Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionAcute Kidney Injury (AKI) following Liver Transplantation (LT) is associated with prolonged ICU and hospital stay, increased risk of chronic renal disease, and decreased graft survival. Intraoperative hypotension is a modifiable risk factor associated with postoperative AKI. We aimed to determine in which phase of LT hypotension has the strongest association with AKI: the anhepatic or neohepatic phase.

methodsThis retrospective cohort study included adult patients undergoing LT between January 2010 and June 2022. Exclusion criteria were re-do or combined transplantations, preoperative dialysis, and early graft failure or death. Primary outcome was AKI as defined by KDIGO. Hypotension was Mean Arterial Pressure (MAP) below predefined thresholds in minutes. Risk adjusted logistic regression analysis considered hypotension in 3 periods: the total procedure, anhepatic phase, and neohepatic phase.

resultsOur cohort included 1153 patients. The median MELD-NA score was 19 (IQR 11-28), and 412 (35.9%) were living-related donations. AKI occurred in 544 patients (47.2%). The unadjusted model showed an association with AKI for MAP < 60 mmHg (OR = 1.011 [1.0, 1.022], p = 0.047) and MAP < 55 mmHg (OR = 1.023 [1.002, 1.047], p = 0.040) in the anhepatic phase, and for MAP < 60 mmHg (OR = 1.032 [1.01, 1.056], p = 0.006) in the neohepatic phase. The adjusted model did not reach significance in the subgroups but did in the total procedure: MAP < 60 mmHg (OR = 1.005 [1.002, 1.008], p < 0.001) and MAP < 55 mmHg (OR = 1.008 [1.003-1.013], p = 0.004).

conclusionIntraoperative hypotension is independently associated with AKI following LT. This association is seen during the anhepatic phase. Maintaining MAP above 60 mmHg may improve kidney function after LT.

Indexed as

Acute Kidney InjuryHypotensionIntraoperative ComplicationsLiver TransplantationAdultAgedCohort StudiesFemaleHumansMaleMiddle AgedPostoperative ComplicationsRetrospective StudiesRisk FactorsAcute kidney injuryBlood pressureHypotensionLiver transplantationPostoperative complicationsReperfusion

Identifiers

PMID39419173
PMCPMC11541844

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.