Vasopressin for Post Kidney Transplant Hypotension
Hypotension after Deceased Donor Kidney Transplant (DDKT) is a risk factor for Delayed Graft Function (DGF), and poor graft survival. We hypothesize that vasopressin use in hypotensive DDKT Recipients to increase blood pressure reduces DGF rates and is safe without increasing mortality.

Group with vasopressin “study group” (n=45) was defined as DDKT Recipients between 2012-2017 who required vasopressin for hypotension SBP <120mmHg or DBP <60mmHg. DDKT Recipients with No-Vasopressin “comparison group” (n=90) were propensity score matched DDKT Recipients between 2012-2017 without vasopressin use. Primary outcomes were graft survival, creatinine and allograft biopsy rate at 1year, DGF rate, and death during transplant hospitalization.

Vasopressin group had lower mean maximum, and minimum systolic and diastolic blood pressure in the operating room. Median vasopressin start-time post-DDKT was 2 hours (IQR 1-6), and duration of use was 42 hours (IQR 24-63) hours. DGF, creatinine at one year and allograft biopsy rates were comparable. No deaths occurred during transplant hospitalization. Multivariable analysis did not find an effect of vasopressin use on Graft Survival.

Treatment of hypotensive DDKT Recipients with vasopressin is safe and facilitated similar graft function and survival with that of non-hypotensive patients. In the absence of a randomized control trial, our study supports the safety of vasopressin therapy to prevent the adverse effects of hypotension.