Evidence map›Paper›PMID 41768785›Full record

ArticleAnesthesiology open2026

Intraoperative Hypotension and Delayed Graft Function after Kidney Transplantation: A Retrospective Cohort Analysis.

Amelie Delaporte, Theodora Wingert, Laurence Weinberg, Tristan Grogan, Kiena Tan, Michael Chen, Jeffrey Veale, Maxime Cannesson, Matthieu Legrand, Dieter Adelmann and 4 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Anesthesiology open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing 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

3 citing papers in PubMed.

  1. Article
  2. Article
  3. New Kidneys Do Not Tolerate Hypotension.Anesthesiology open · 2026
    Article
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

14 authors.

Amelie DelaporteAmelie Delaporte, M.D., Theodora Wingert, M.D., Maxime Cannesson, M.D., Ph.D., and Alexandre Joosten, M.D., Ph.D.: Department of Anesthesiology and Perioperative Medicine, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, California.
Theodora WingertAmelie Delaporte, M.D., Theodora Wingert, M.D., Maxime Cannesson, M.D., Ph.D., and Alexandre Joosten, M.D., Ph.D.: Department of Anesthesiology and Perioperative Medicine, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, California.
Laurence WeinbergLaurence Weinberg, M.D., Ph.D.: Department of Anesthesia, Austin Health, University of Melbourne, Melbourne, Victoria, Australia.
Tristan GroganTristan Grogan, M.S.: Department of Medicine Statistics Core, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California.
Kiena TanKiena Tan, B.S.: University of California, Los Angeles, Los Angeles, California.
Michael ChenMichael Chen, M.D., and Jeffrey Veale, M.D.: Department of Urology, Kidney Transplant Exchange Program, University of California, Los Angeles Health, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, California.
Jeffrey VealeMichael Chen, M.D., and Jeffrey Veale, M.D.: Department of Urology, Kidney Transplant Exchange Program, University of California, Los Angeles Health, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, California.
Maxime CannessonAmelie Delaporte, M.D., Theodora Wingert, M.D., Maxime Cannesson, M.D., Ph.D., and Alexandre Joosten, M.D., Ph.D.: Department of Anesthesiology and Perioperative Medicine, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, California.
Matthieu LegrandMatthieu Legrand, M.D., Ph.D.: Department of Anesthesia and Perioperative Care, University of California, San Francisco, San Francisco, California.
Dieter AdelmannDieter Adelmann, M.D., Ph.D., and Anatole Harrois, M.D., Ph.D.: Department of Anesthesiology, Université Paris-Saclay, Hôpital Bicetre, Assistance Publique Hôpitaux de Paris, Le Kremlin Bicêtre, France.
Anatole HarroisDieter Adelmann, M.D., Ph.D., and Anatole Harrois, M.D., Ph.D.: Department of Anesthesiology, Université Paris-Saclay, Hôpital Bicetre, Assistance Publique Hôpitaux de Paris, Le Kremlin Bicêtre, France.
Renaud SnanoudjRenaud Snanoudj, M.D., Ph.D.: Department of Nephrology, Université Paris-Saclay, Hôpital Bicetre, Assistance Publique Hôpitaux de Paris, Le Kremlin Bicêtre, France.
Francois Martin CarrierFrancois Martin Carrier, M.D., Ph.D.: Department of Anesthesiology and Department of Medicine, Critical Care Division, University Hospital of Montreal, Montréal, Québec, Canada.
Alexandre JoostenAmelie Delaporte, M.D., Theodora Wingert, M.D., Maxime Cannesson, M.D., Ph.D., and Alexandre Joosten, M.D., Ph.D.: Department of Anesthesiology and Perioperative Medicine, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, California.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Delayed graft function is a major postoperative complication after kidney transplantation, increasing the risk of both early and late graft loss. Although many preoperative, surgical, and donor-related risk factors are unmodifiable, intraoperative hypotension may contribute to reduced kidney perfusion and affect delayed graft function incidence. However, the impact of intraoperative hypotension on the risk of delayed graft function has not been rigorously examined. It was hypothesized that intraoperative hypotension is associated with increased odds of delayed graft function after kidney transplantation. Methods: This single-center retrospective cohort study included all consecutive patients with chronic renal failure who underwent first kidney transplantation from a deceased or living donor between 2013 and 2024. Combined transplant procedures were excluded. Intraoperative hypotension was quantified as the area under the curve (AUC) for a mean arterial pressure (MAP) less than 65 mmHg, capturing both duration and severity of intraoperative hypotension. The primary outcome was delayed graft function, defined as a dialysis requirement within the first postoperative week. Multivariable logistic regression, adjusting for prespecified clinically chosen recipient, intraoperative, and donor confounders, was used to assess the association between intraoperative hypotension and delayed graft function. Results: Among 3,825 kidney transplants (68% deceased donors, 32% living donors), the median (Q1, Q3) AUC for MAP less than 65 mmHg was 12 (0, 78) mmHg·min. Delayed graft function occurred in 1,007 patients (26.3% of all cases, 37.5% deceased donors, 3.1% living donors). Each 50 mmHg·min increase in AUC for MAP less than 65 mmHg was associated with higher odds of delayed graft function (adjusted odds ratio, 1.08; 95% CI, 1.02 to 1.14; Conclusions: Greater duration and severity of intraoperative hypotension were associated with increased incidence of delayed graft function after kidney transplantation. Although causality cannot be established, these findings highlight the potential importance of avoiding low pressure in this vulnerable population. Transplant-specific studies, including randomized trials, are needed to determine optimal intraoperative MAP targets and clarify hemodynamic strategies that may improve graft outcomes.

Identifiers

PMID41768785
PMCPMC12939988

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Registered trials

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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.