ArticleWorld journal of transplantation2026
Total intravenous anesthesia in kidney transplantation: A narrative review.
Article in World journal of transplantation, 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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5 authors.
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Abstract
backgroundKidney transplantation is the treatment of choice for end-stage renal disease. Whether propofol-based total intravenous anaesthesia (TIVA) confers advantages over volatile anaesthesia for perioperative stability, recovery, and graft outcomes remains debated.
aimTo synthesise the currently available comparative evidence on propofol-based TIVA versus volatile anaesthesia in adult kidney transplantation-focusing on haemodynamic stability, renal injury biomarkers, early graft function, recovery, postoperative nausea and vomiting (PONV), immunologic outcomes, and safety-and to identify the key evidence gaps and priorities for future research.
methodsWe performed a narrative review following the Scale for the Assessment of Narrative Review Articles framework, with structured search and selection consistent with PRISMA-S reporting. PubMed/MEDLINE, EMBASE, Cochrane CENTRAL, Scopus, and Web of Science were searched from inception to February 2026. Quality was appraised using Cochrane Risk of Bias 2 and ROBINS-I. Six studies were directly eligible in adult kidney transplant recipients; four supplementary mechanistic sources informed interpretation.
resultsTIVA provided haemodynamic stability and immediate graft function equivalent to volatile anaesthesia. Urinary tubular biomarkers (kidney injury molecule-1, N-acetyl-β-D-glucosaminidase) were modestly lower with propofol in the VAPOR-1 trial (
conclusionPropofol-based TIVA is a safe and effective alternative to volatile anaesthesia in kidney transplantation. Whether the cellular-level biomarker signal translates into clinically meaningful renoprotection in higher-risk grafts requires adequately powered multicentre trials with standardised perioperative protocols.
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