Is There a Relationship Between Intraoperative Hemodynamic Instability and Calcineurin Inhibitor-Related Toxicity, Early After Liver Transplantation? A Single-Center Observational Study

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Abstract

This study evaluated the relationship between intraoperative hemodynamic instability (IOHI) and the development of calcineurin inhibitor (CNI) toxicity in the early postoperative period after liver transplantation (LT). Eighty-two patients were enrolled during a 1-year period and a 3-month follow-up. IOHI, requiring continuous infusion of vasopressors, was observed in 31 patients (38\%, group 1; control group 2, n = 51). Acute kidney injury (AKI) developed in 28 patients (52\% in group 1 vs 24\% in group 2, P = .02), and CNI-related neurotoxicity (CNI-NT) in 26 (48\% in group 1 vs 22\% in group 2, P = .03). Group 1 patients received mainly deceased donor grafts (87\% vs 57\% in group 2, P < .001). An independent association between IOHI and CNI-NT (P = .029) and AKI (P = .016) was observed. The receiver-operator characteristic curve revealed an area under the curve of 0.63 for IHI (sensitivity 56\%; specificity 75\%) and 0.65 for AKI (sensitivity 56\%; specificity 70.2\%). In conclusion, patients undergoing LT with IOHI may be more prone to developing CNI-NT and AKI in the early postoperative period.
Original languageEnglish
Pages (from-to)1789-1793
Number of pages5
JournalTransplantation Proceedings
Volume46
Issue number6
DOIs
Publication statusPublished - 2014

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