July 28, 2025

Low blood pressure after kidney transplant linked to poorer outcomes

A recent study shows that low blood pressure around the time of kidney transplant surgery is linked to a higher risk of complications. Patients with low blood pressure during or shortly after surgery were more likely to experience delayed kidney function and, in the long term, complete loss of function in the transplanted kidney. 

Perioperative hypotension (POH)—a drop in blood pressure around the time of surgery—has previously been linked to kidney damage, but its effects on transplanted kidneys were not well understood. To explore this, Steven A. Morrison and colleagues at Dalhousie University in Halifax, Nova Scotia, analyzed data from more than 300 transplant patients who experienced either brief drops in blood pressure during surgery (intraoperative hypotension, or IOH) or longer-lasting drops within two days of surgery (POH). 

The results show that 36.6 per cent of patients with POH experienced delayed kidney function, compared to just 12.5 per cent of those without POH. In patients who were followed for several years after their transplant, POH was also associated with a higher risk of graft loss—which is when the transplanted kidney stops working entirely. This effect was especially pronounced in men with POH, which researchers suggest may be due to hormonal differences, although more research is needed to understand why POH affects men and women differently.