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Updated: May 19, 2026
Organ Ischemia-Reperfusion Injury by Simulating Hemodynamic Changes in Rat Liver Transplant Model
Published on: March 6, 2021
Intraoperative Hemodynamic Management during Liver Transplantation and Postoperative Morbidity: A Multicenter Cohort
François M Carrier1, Steve Ferreira Guerra2, Maxim Soucy-Proulx3
1François M. Carrier, M.D., Ph.D.: Department of Anesthesiology, University of Montreal Health Center, Montréal, Canada; Department of Medicine, Critical Care Division, University of Montreal Health Center, Montréal, Canada; Health Innovation and Evaluation Hub, University of Montreal Health Center Research Center, Montréal, Canada; and Department of Anesthesiology and Pain Medicine, University of Montreal, Montréal, Canada.
Intraoperative fluid balance and vasopressor doses did not impact early graft function after liver transplantation. This study found no association between hemodynamic management and 7-day graft dysfunction or non-function.
Area of Science:
- Transplantation Medicine
- Anesthesiology
- Critical Care Medicine
Background:
- Optimal intraoperative hemodynamic management in liver transplantation is not well-defined.
- Limited high-quality studies exist on the link between intraoperative hemodynamics and postoperative outcomes.
- This study investigates fluid balance and vasopressor use in relation to early graft outcomes.
Purpose of the Study:
- To assess the association between intraoperative fluid balance and vasopressor doses with 7-day early allograft dysfunction or primary graft non-function.
- To evaluate the relationship between hemodynamic management and other postoperative complications following liver transplantation.
Main Methods:
- Multicenter cohort study involving 8 liver transplant centers.
- Included 852 liver transplant recipients between January 2021 and May 2023.
- Analyzed intraoperative fluid balance and vasopressor doses (norepinephrine equivalents) against 7-day graft outcomes using adjusted regression models.
Main Results:
- The incidence of 7-day early allograft dysfunction or primary graft non-function was 28%.
- Neither fluid balance (RR=1.02) nor vasopressor doses (RR=1.03) showed a significant association with the primary outcome.
- No link was found between higher fluid balance or vasopressor doses and increased risk of early graft dysfunction.
Conclusions:
- Higher intraoperative fluid balance was not associated with increased risk of 7-day early allograft dysfunction or primary graft non-function.
- Higher intraoperative vasopressor doses were not associated with increased risk of 7-day early allograft dysfunction or primary graft non-function.
- Current findings suggest that these specific hemodynamic parameters may not be critical drivers of early graft failure in liver transplantation.
