Vasopressin for Post-kidney Transplant Hypotension
Muhammad Y Jan1, Sharon M Moe1,2, Oluwafisayo Adebiyi1
1Division of Nephrology and Hypertension, Indiana University School of Medicine, Indianapolis, Indiana, USA.
Kidney International Reports
|June 13, 2022
Summary
Vasopressin use in kidney transplant recipients with hypotension is safe and does not increase mortality. This treatment led to comparable graft function and survival rates, supporting its use to prevent negative effects of low blood pressure.
Area of Science:
- Nephrology
- Transplant Surgery
- Critical Care Medicine
Background:
- Hypotension post-deceased donor kidney transplant (DDKT) is linked to delayed graft function (DGF) and reduced graft survival (GS).
- Effective management of hypotension is crucial for optimizing DDKT outcomes.
Purpose of the Study:
- To evaluate the safety and efficacy of vasopressin in treating hypotension in DDKT recipients.
- To determine if vasopressin use impacts DGF rates and long-term graft survival.
Main Methods:
- Retrospective analysis of DDKT recipients (2012-2017).
- Comparison of a vasopressin group (n=45) with a propensity score-matched no-vasopressin control group (n=90).
- Primary outcomes included GS, creatinine, allograft biopsy rates at 1 year, DGF, and in-hospital mortality.
Main Results:
- The vasopressin group experienced lower systolic and diastolic blood pressures in the operating room.
- Vasopressin was initiated a median of 2 hours post-transplant and used for a median of 42 hours.
- No significant differences were observed in DGF, 1-year creatinine, allograft biopsy rates, or in-hospital mortality between groups.
Conclusions:
- Vasopressin treatment for hypotension in DDKT recipients is safe.
- It facilitates comparable graft function and survival to non-hypotensive patients.
- Supports the use of vasopressin to mitigate adverse effects of hypotension in DDKT.
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