Impact of intraoperative blood pressure hypotension on kidney transplant recipients: a retrospective analysis
https://doi.org/10.13181/mji.oa.268481
- Author:
Maruhum Bonar Hasiholan Marbun
1
;
Nur Rasyid
2
;
Dita Aditianingsih
3
;
Dina Elita
1
;
Priscilla Geraldine Nainggolan
1
;
Michella Chiara Heriyanto
1
;
Jesslyn Mellenia
1
;
Angela Rebecca Tiurmarina Sintauli Hutagulung
1
Author Information
1. Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
2. Department of Urology, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
3. Department of Anesthesia, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
- Publication Type:Journal Article
- Keywords:
blood pressure;
delayed graft function;
graft rejection;
kidney transplantation;
mortality
- MeSH:
blood pressure;
delayed graft function;
graft rejection;
kidney transplantation;
mortality
- From:
Medical Journal of Indonesia
2026;35(3):208-214
- CountryIndonesia
- Language:English
-
Abstract:
BACKGROUND :Kidney transplantation improves survival and quality of life in end-stage renal disease. However, intraoperative hypotension remains common and may reduce graft perfusion. The optimal intraoperative blood pressure (BP) target remains unclear. This study aimed to evaluate the association between intraoperative BP trends and kidney transplant outcomes.
METHODS :A retrospective cohort study was conducted among adult living donor kidney transplant recipients (≥18 years) at Cipto Mangunkusumo Hospital, Jakarta, Indonesia, from July 2023–April 2025. Intraoperative BP was recorded every 15 min to calculate average, minimum, and hourly systolic blood pressure (SBP), diastolic blood pressure, and mean arterial pressure (MAP). The primary outcomes were 3-month mortality, delayed graft function (DGF), and acute allograft rejection. Secondary outcomes included early graft function parameters, including serum creatinine levels, estimated glomerular filtration rate (eGFR), and time to first diuresis. Associations between BP and outcomes were analyzed using multivariate logistic regression in SPSS software version 27.0, with p<0.05 considered significant.
RESULTS :Of 79 transplant recipients, the 3-month mortality was 6.3%, DGF was 7.6%, and acute rejection was 3.8%. Lower intraoperative MAP was associated with increased odds of DGF, with MAP <80 mmHg showing the strongest association (odds ratio [OR]: 88.239; 95% confidence interval [CI]: 2.720–2,092.86). Each 10-mmHg increase in overall SBP was associated with a reduction in the odds of DGF (OR: 0.360; 95% CI: 0.155–0.838). No BP measures were linked to serum creatinine levels (p = 0.083–0.271) or eGFR (p = 0.151–0.791).
CONCLUSIONS :Lower intraoperative MAP and SBP were associated with higher odds of DGF, highlighting the importance of maintaining adequate BP to optimize kidney transplant outcomes.
- Full text:202611051032248766035-3-8481-Maruhum-Bonar-Hasiholan-Marbun_xmp.pdf
