Abstract: SA-PO1174
Perioperative Vasopressor Exposure Is Associated with Delayed Graft Function After Adult Kidney Transplantation: A Systematic Review and Meta-Analysis
Session Information
- Transplantation: Clinical - Complications, Pediatrics, and Multi-Organ Considerations
October 24, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Transplantation
- 2002 Transplantation: Clinical
Authors
- Landivar, Maria Clara, Universidad San Francisco de Quito, Quito, Pichincha, Ecuador
- Velarde-Pineda, Ana A., Universidad de Guadalajara, Guadalajara, Jal., Mexico
- Faizollah Zadeh Ardebili, Saman, Univerzita Karlova, Prague, Czechia
- Ramirez-Paliza, Yuri, Universidad Peruana Cayetano Heredia, Lima District, Lima Region, Peru
- Arslan, Felemez, Saglik Bilimleri Universitesi, Istanbul, Turkey
Background
Delayed graft function (DGF) is a common complication after kidney transplantation. Although several donor, recipient, and transplant-related predictors are established, the role of modifiable intraoperative hemodynamic factors remains uncertain.
Methods
We searched three bibliographic databases (Pubmed, EMBASE, Cochrane) for cohort or case-control studies of adult kidney transplant recipients evaluating recipient intra- or perioperative vasopressor exposure with graft outcomes. Our primary outcome was DGF or closely related early graft dysfunction. Odds ratios (ORs) were pooled with 95% confidence intervals (CIs) using a random-effects model.
Results
Of 1,104 records screened and 32 full texts reviewed, seven reports representing six independent cohorts were included, comprising 5,486 adult kidney transplant episodes. Perioperative vasopressor exposure was associated with higher odds of DGF (OR 1.87; 95% CI 1.41–2.47; p<0.001; I2=8%; Fig. 1A). This association persisted in a two-study adjusted analysis (adjusted OR 2.53; 95% CI 1.38–4.64; p=0.003; I2=0%). Intraoperative hypotension was also associated with higher odds of DGF or early graft dysfunction (OR 1.76; 95% CI 1.27–2.44; p=0.0007; I2=26%; Fig. 1B). Other renal and safety outcomes were inconsistently reported.
Conclusion
Perioperative recipient vasopressor exposure and intraoperative hypotension were associated with DGF or early graft dysfunction after adult kidney transplantation. These findings may reflect underlying hemodynamic instability rather than direct vasopressor harm, and support prospective studies defining optimal blood pressure targets, fluid strategy, and vasopressor selection during kidney transplantation.