{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T00:59:07Z","timestamp":1792630747773,"version":"4.5.0"},"reference-count":37,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2024,10,26]],"date-time":"2024-10-26T00:00:00Z","timestamp":1729900800000},"content-version":"vor","delay-in-days":25,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Transplantation"],"published-print":{"date-parts":[[2024,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Intraoperative hypotension is associated with acute kidney injury after surgery. However, the definition (duration and magnitude) of hypotension during kidney transplantation (KT) surgery on early graft function remains unclear.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted a retrospective cohort study of KT recipients from December 1, 2009, to December 31, 2019. Exposure to intraoperative hypotension was characterized as the duration (minutes) of mean arterial pressure (MAP) &lt;55, &lt;65, &lt;75, and &lt;85\u00a0mmHg. Our co\u2010primary outcomes were DGF\u2010creatinine reduction ratio (DGF\u2010CRR, &lt;30% creatinine reduction, postoperative days 1 and 2), and DGF\u2010dialysis (DGF\u2010D, required dialysis within the week of KT for deceased donor recipients). Logistic regression models were fitted to assess this relationship between MAP and DGF.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We included 1602 KT (939 deceased donors, 663 living donors) and 23 were excluded. DGF\u2010CRR occurred in 33% of patients. DGF\u2010CRR was associated with MAP\u00a0&lt;\u00a065 (&gt;5\u00a0min: OR 1.77, 95% confidence interval [CI]: 1.39\u20132.30; 6\u201310\u00a0min: OR 1.67, 95% CI: 0.97\u20132.86; 11\u201320\u00a0min: OR 2.18, 95% CI: 1.31\u20133.63) in unadjusted and &lt;55\u00a0mmHg (5 min: OR 1.85, 95% CI: 1.47\u20132.32; 5\u201310\u00a0min: OR 2.41, 95% CI: 1.65\u20133.53; 11\u201320\u00a0min: OR 2.36, 95% CI: 1.60, 3.48) in adjusted models. There was also a signal for increased risk of DGF\u2010CRR at MAP\u00a0&lt;\u00a075 (&gt;5\u00a0min: OR 1.69, 95% CI: 1.02\u20132.80). DGF\u2010D (incidence 35%) in deceased donor KT was not associated with hypotension.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>We found an association between intraoperative hypotension and DGF\u2010CRR at a threshold MAP of 55\u00a0mmHg, with a consistent signal toward increased risk at both 65 and 75\u00a0mmHg, as indicated by unadjusted models.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ctr.70000","type":"journal-article","created":{"date-parts":[[2024,10,26]],"date-time":"2024-10-26T11:04:58Z","timestamp":1729940698000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Association of Intraoperative Hypotension With Delayed Graft Function Following Kidney Transplant: A Single Centre Retrospective Cohort Study"],"prefix":"10.1111","volume":"38","author":[{"given":"Marc","family":"Sicova","sequence":"first","affiliation":[{"name":"Department of Anesthesia and Pain Management Toronto General Hospital \u2013 University Health Network  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryan","family":"McGinn","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Pain Management Toronto General Hospital \u2013 University Health Network  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophia","family":"Emerson","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Pain Management Toronto General Hospital \u2013 University Health Network  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paula","family":"Perez","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Pain Management Toronto General Hospital \u2013 University Health Network  Toronto Ontario Canada"},{"name":"Department of Anesthesiology and Pain Medicine, Temerty Faculty of Medicine University of Toronto  Toronto Ontario 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University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ian","family":"Randall","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Pain Management Toronto General Hospital \u2013 University Health Network  Toronto Ontario Canada"},{"name":"Department of Anesthesiology and Pain Medicine, Temerty Faculty of Medicine University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4361-1656","authenticated-orcid":false,"given":"Daniel Santa","family":"Mina","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Pain Management Toronto General Hospital \u2013 University Health Network  Toronto Ontario Canada"},{"name":"Faculty of Kinesiology and Physical Education University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Santema","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Pain Management Toronto General Hospital \u2013 University Health Network  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Duminda N.","family":"Wijeysundera","sequence":"additional","affiliation":[{"name":"Department of Anesthesia St. Michael's Hospital  Toronto Ontario Canada"},{"name":"Department of Anesthesia Unity Health Toronto \u2013 St. Michael's Hospital  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wilton","family":"Van Klei","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Pain Management Toronto General Hospital \u2013 University Health Network  Toronto Ontario Canada"},{"name":"Department of Anesthesiology and Pain Medicine, Temerty Faculty of Medicine University of Toronto  Toronto Ontario Canada"},{"name":"Department of Anesthesiology Intensive Care and Emergency Medicine University Medical Center Utrecht  Utrecht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5021-9831","authenticated-orcid":false,"given":"S. Joseph","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Medicine (Nephrology) and the Ajmera Transplant Centre University Health Network University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6684-0497","authenticated-orcid":false,"given":"Stuart A.","family":"McCluskey","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Pain Management Toronto General Hospital \u2013 University Health Network  Toronto Ontario Canada"},{"name":"Department of Anesthesiology and Pain Medicine, Temerty Faculty of Medicine University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,10,26]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.05021107"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1034\/j.1600-6143.2003.00146.x"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.JAA.0000545074.86472.d4"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.5812\/numonthly.12182"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12882-020-02181-1"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12882-022-02777-9"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1159\/000491558"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.2009040412"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/TXD.0000000000001433"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13063-021-05989-w"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm10081634"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.transproceed.2023.04.029"},{"key":"e_1_2_9_14_1","first-page":"1","article-title":"The UNOS Renal Transplant Registry","author":"Cecka J. 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