Clinical application of intraoperative somatic tissue oxygen saturation for detecting postoperative early kidney dysfunction patients undergoing living donor liver transplantation: A propensity score matching analysis

BACKGROUND: Somatic tissue oxygen saturation (SstO(2)) is associated with systemic hypoperfusion. Kidney dysfunction may lead to increased mortality and morbidity in patients who undergo living donor liver transplantation (LDLT). We investigated the clinical utility of SstO(2) during LDLT for identifying postoperative kidney dysfunction. PATIENTS AND METHODS: Data from 304 adults undergoing elective LDLT between January 2015 and February 2020 at Seoul St. Mary’s Hospital were retrospectively collected. Thirty-six patients were excluded based on the exclusion criteria. In total, 268 adults were analyzed, and 200 patients were 1:1 propensity score (PS)-matched. RESULTS: Patients with early kidney dysfunction had significantly lower intraoperative SstO(2) values than those with normal kidney function. Low SstO(2) (< 66%) 1 h after graft reperfusion was more highly predictive of early kidney dysfunction than the values measured in other intraoperative phases. A decline in the SstO(2) was also related to kidney dysfunction. CONCLUSIONS: Kidney dysfunction after LDLT is associated with patient morbidity and mortality. Our results may assist in the detection of early kidney dysfunction by providing a basis for analyzing SstO(2) in patients undergoing LDLT. A low SstO(2) (< 66%)(,) particularly 1 h after graft reperfusion, was significantly associated with early kidney dysfunction after surgery. SstO(2) monitoring may facilitate the identification of early kidney dysfunction and enable early management of patients.