Goal-Directed Hemodynamic Therapy in Deceased-Donor Kidney Transplantation: A Prospective Paired-Kidney Study.
J Cardiothorac Vasc AnesthMay 23, 2026 (epub)
Van Trinh Vu, Ba Tuan Nguyen, Thi Kim Dung Dao et al.
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In 30 seconds
This randomized controlled trial evaluated goal-directed hemodynamic therapy (GDHT) using FloTrac in 40 patients undergoing deceased-donor kidney transplantation. The GDHT group received significantly less intravenous fluid (1,385.0 ± 259.6 mL vs 1,958.0 ± 877.0 mL, p = 0.011) and reduced reliance on rescue vasopressors (45.0% vs 100%, p = 0.001) compared to standard CVP-guided therapy, while maintaining equivalent mean arterial pressure.
Key findings
- GDHT group received 1,385.0 ± 259.6 mL of fluid compared to 1,958.0 ± 877.0 mL in the control group (p = 0.011).
- GDHT cohort had a higher early stroke volume index at 15 minutes postinduction (p = 0.033).
- Lower CVP levels were maintained throughout surgery in the GDHT group (p = 0.002).
- Rescue vasopressor use was reduced to 45.0% in the GDHT group compared to 100% in the control group (p = 0.001).
Why it matters
Optimizing intraoperative hemodynamics through GDHT may enhance early graft function and reduce complications associated with fluid overload and vasopressor use, which is crucial in kidney transplantation.