{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,12]],"date-time":"2026-11-12T10:03:17Z","timestamp":1794477797523,"version":"4.9.1"},"reference-count":21,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"Suppl 1","license":[{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background and Aims:<\/jats:title>\n                    <jats:p>Intra-operative hypotension (IOH) adversely affects renal graft and recipient outcomes. The Hypotension Prediction Index (HPI), a machine learning-based algorithm, predicts IOH. This study compared HPI- versus pulse pressure variation (PPV)-guided haemodynamic management in kidney transplantation, hypothesising that HPI guidance would reduce intra-operative hypotension.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      In this single-centre randomised controlled trial, 82 patients with end-stage renal disease (ESRD) undergoing live-related kidney transplantation under general anaesthesia were randomised to HPI-guided (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 41) or PPV-guided (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 41) haemodynamic management. The primary outcome was the time-weighted average area under the threshold (TWA-AUT) of mean arterial pressure (MAP) &lt;65 mmHg. Secondary outcomes included absolute area under the threshold (AUT), the number and total duration of hypotensive episodes per patient, and the proportion of patients with MAP &lt;50 mmHg. Delayed graft function, serum creatinine on post-operative day 3, hospital stay, and 90-day mortality were also compared.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      The results were analysed for 82 patients. The median [interquartile range (IQR)] TWA-AUT &lt;65 mmHg was 0.10 mmHg [0.04\u20130.17] in the HPI group and 0.16 mmHg [0.06\u20130.32] in the PPV group, with a median difference of \u20130.05 mmHg [95% confidence interval (CI): \u20130.18 to 0.01;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.09]. The median AUT was 24.8 mmHg\u00b7min in the HPI group and 43.3 mmHg \u00d7 min in the PPV group (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.10). Hypotensive events occurred in 47% of patients in the HPI group versus 61% in the PPV group (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.16). No significant differences were observed in the secondary outcomes between the groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>HPI-guided haemodynamic management did not significantly reduce the time-weighted average of intra-operative hypotension during renal transplant surgery compared to PPV-guided haemodynamic management.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/ija.ija_1519_25","type":"journal-article","created":{"date-parts":[[2026,1,30]],"date-time":"2026-01-30T13:00:24Z","timestamp":1769778024000},"page":"S50-S58","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":3,"title":["Comparison of the Hypotension Prediction Index and pulse pressure variation-guided haemodynamic management for intra-operative hypotension during kidney transplant: A randomised controlled trial"],"prefix":"10.4103","volume":"70","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8381-9975","authenticated-orcid":false,"given":"Ashish S.","family":"Aditya","sequence":"first","affiliation":[{"name":"Department of Anaesthesia and Intensive Care, Postgraduate Institute of Medical Education and Research, Chandigarh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3271-0122","authenticated-orcid":false,"given":"Kamal","family":"Kajal","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia and Intensive Care, Postgraduate Institute of Medical Education and Research, Chandigarh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8429-9163","authenticated-orcid":false,"given":"Sameer","family":"Sethi","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia and Intensive Care, Postgraduate Institute of Medical Education and Research, Chandigarh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2961-4148","authenticated-orcid":false,"given":"Madhumita","family":"Premkumar","sequence":"additional","affiliation":[{"name":"Department of Hepatology, Postgraduate Institute of Medical Education and Research, Chandigarh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3868-0473","authenticated-orcid":false,"given":"Naveen","family":"Naik","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia and Intensive Care, Postgraduate Institute of Medical Education and Research, Chandigarh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3349-4417","authenticated-orcid":false,"given":"Ashish","family":"Sharma","sequence":"additional","affiliation":[{"name":"Renal Transplant Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, 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