Phenotype Guided Vasoactive Medication During Kidney Transplantation

Intraoperative Circulation Phenotyping to Guide Vasoactive Medication in Kidney Transplant Recipients

The goal of this clinical trial is to learn if vasopressin improves the body's response to intravenous fluids during kidney transplantation in patients who have relaxed blood vessels. Researchers will compare the results of vasopressin to those who received calcium chloride.

This prospective, single-arm interventional study evaluates a phenotype-guided vasoactive protocol during adult kidney transplantation. Intraoperative monitoring includes pulse contour analysis and repeated FPC testing. Based on predefined phenotype criteria, vasoactive support is assigned as follows: vasopressin infusion for Hyperdynamic physiology, norepinephrine infusion for Mixed Physiology, calcium chloride boluses and/or low-dose dopamine infusion for Poor Contractility, and fluid-guided management for Normal physiology.

Inclusion Criteria:

• Adults aged 18 years or older
• Undergoing kidney transplantation at Cedars-Sinai Medical Center
• Able to provide informed consent

Exclusion Criteria:

• Patients unable to provide informed consent
• Patients with contraindications to protocol vasoactive medications, as determined by the treating anesthesiologist
• Patients in whom required intraoperative monitoring cannot be performed