How important is intraoperative blood pressure for surgical outcomes?

Q: What are the key findings of this study?

Moderate-to-severe intraoperative hypotension, such as MAP < 55 mmHg for 43 minutes or longer, is independently associated with increased 1-year mortality after liver transplantation.

Q: What is the clinical evidence from this study?

Study design: Editorial. Population: Liver transplantation (n=1063). Intervention: Moderate-to-severe intraoperative hypotension vs. Absence of moderate-to-severe hypotension. Primary outcome: 1-year mortality.

Bon‐Wook Koo

doi:10.4097/kja.26724

July 7, 2026Korean Journal of AnesthesiologyOpen Access

How important is intraoperative blood pressure for surgical outcomes?

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Key result

Moderate-to-severe intraoperative hypotension linked to higher 1-year mortality after liver transplantation.

n=1,063

Key Points

To examine the prognostic significance of intraoperative blood pressure and evaluate organ-specific hemodynamic thresholds during liver, kidney, and heart transplantation.
Editorial synthesis evaluating evidence on intraoperative hypotension, focusing on a retrospective cohort of 1063 adult liver transplant recipients alongside kidney and heart transplant studies.
Assessed depth and cumulative duration of exposure to various mean arterial pressure (MAP) thresholds relative to graft function and mortality.
In 1063 adult liver transplant recipients, prolonged MAP < 65 or < 60 mmHg was not independently linked to mortality, whereas MAP < 55 mmHg for ≥ 43 min, < 50 mmHg for ≥ 14 min, < 45 mmHg for ≥ 13 min, and < 40 mmHg for ≥ 5 min were associated with worse 1-year survival.
In kidney transplantation, intraoperative hypotension around an MAP of 55 mmHg correlates with slow and delayed graft function due to altered recipient autoregulation and reperfusion demands.
In heart transplantation, hypotension serves as a marker for low cardiac output and primary graft dysfunction, necessitating MAP maintenance of at least 60–65 mmHg combined with perfusion monitoring.

PICO

P

Population

1,063 adult liver transplant recipients evaluated for the association between the depth and duration of intraoperative hypotension and 1-year mortality.

E

Exposure / Comparator

Moderate-to-severe intraoperative hypotension vs Absence of moderate-to-severe hypotension

O

Primary Outcome

1-year mortality

Implication

Editorial review demonstrates organ-specific prognostic thresholds for intraoperative hypotension in transplantation recipients, highlighting the need for individualized hemodynamic targets.

Abstract

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Discussion

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Cite This Study

Bon‐Wook Koo (2026) conducted an editorial in Liver transplantation (n=1,063). Moderate-to-severe intraoperative hypotension vs. Absence of moderate-to-severe hypotension was evaluated on 1-year mortality. Moderate-to-severe intraoperative hypotension, such as MAP < 55 mmHg for 43 minutes or longer, is independently associated with increased 1-year mortality after liver transplantation.

synapsesocial.com/papers/6a4f3e1f2b81a944af575e22 https://doi.org/10.4097/kja.26724

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How important is intraoperative blood pressure for surgical outcomes?

Key Points

PICO

Implication

Abstract

Discussion

Cite This Study

How important is intraoperative blood pressure for surgical outcomes?

Key Points

PICO

Implication

Abstract

Discussion

Cite This Study

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