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Published on: April 27, 2019
Vasoactive-Inotropic Score in Orthotopic Liver Transplantation: A Retrospective Observational Study.
Cristian Ursella1, Serena Tomasino2, Francesco Meroi3
1Department of Medicine, University of Udine, Udine, Italy.
Summary
The Vasoactive-Inotropic Score (VIS) after liver transplant predicts acute kidney injury (AKI) and mortality. Higher VIS scores indicate increased risk for adverse outcomes, including longer ventilation and ICU stays.
Area of Science:
- Transplant Surgery
- Nephrology
- Critical Care Medicine
Background:
- Orthotopic liver transplantation (OLTx) is a complex procedure with significant perioperative risks.
- Assessing patient risk and predicting outcomes is crucial for optimizing care after OLTx.
- The Vasoactive-Inotropic Score (VIS) is a quantitative measure of hemodynamic support, but its role in OLTx is not fully established.
Purpose of the Study:
- To investigate the association between the Vasoactive-Inotropic Score (VIS) and the occurrence of acute kidney injury (AKI) within 7 days post-OLTx.
- To evaluate the correlation of VIS with 30-day and 1-year mortality following OLTx.
- To examine the relationship between VIS and cardiovascular events, mechanical ventilation duration, and ICU length of stay.
Main Methods:
- A single-center retrospective observational study was conducted.
- Data from 144 patients who underwent OLTx between January 2018 and November 2023 were analyzed.
- VIS was calculated intraoperatively and postoperatively to assess hemodynamic status.
Main Results:
- Postoperative VIS demonstrated a significant correlation with the incidence of AKI (OR, 1.06; p = 0.03).
- Patients with a postoperative VIS > 10 had a substantially higher risk of AKI compared to those with VIS < 5 (OR, 3.63; p = 0.006).
- VIS correlated significantly with both 30-day and 1-year mortality, as well as the duration of mechanical ventilation and ICU length of stay.
Conclusions:
- The Vasoactive-Inotropic Score (VIS), particularly when calculated within 24 hours post-OLTx, is a significant predictor of AKI in the early postoperative period.
- Both intraoperative and postoperative VIS values are independently associated with increased 30-day and 1-year mortality.
- VIS serves as a valuable tool for risk stratification and predicting resource utilization, such as mechanical ventilation and ICU stay, in liver transplant recipients.
