ArticleScientific reports2026
Intraoperative renal oxygen saturation trajectories are associated with early postoperative acute kidney injury after liver transplantation.
Article in Scientific reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Acute kidney injury (AKI) is frequent after liver transplantation, yet kidney-specific real-time intraoperative monitoring is limited. We hypothesized that intraoperative renal regional oxygen saturation (rSkO₂) trajectories—particularly a rapid decline—are independently associated with AKI within 7 days after liver transplantation. In this single-center prospective cohort (January 2022–January 2024), adults undergoing liver transplantation with baseline eGFR ≥ 60 mL/min/1.73 m² and total bilirubin ≤ 300 µmol/L underwent continuous bilateral renal near-infrared spectroscopy monitoring (INVOS 5100 C). Latent growth mixture modelling classified rSkO₂ trajectories and derived a rapid-decline threshold (> 22.6% drop within 5 min). The primary endpoint was KDIGO 2012 creatinine-defined AKI within 7 days. Among 185 liver transplant recipients, a rapid renal rSkO₂ drop (> 22.6% within 5 min) occurred in 32 (17%). Patients with a rapid drop had a higher risk of 7-day AKI than those without (66% vs. 30%), and the rapid drop was independently associated with AKI (adjusted OR 8.54, 95% CI 2.97–24.57). A rapid intraoperative renal rSkO₂ decline was associated with a higher risk of early postoperative AKI after liver transplantation and may help identify patients at increased perioperative renal risk.
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