Vasoactive-Inotropic Score in Orthotopic Liver Transplantation: A Retrospective Observational Study

Objectives: The authors explored the potential role of the Vasoactive-Inotropic Score (VIS), calculated both intraoperatively and postoperatively, in patients undergoing orthotopic liver transplantation (OLTx). The primary outcome was the association between the VIS and the occurrence of acute kidney injury (AKI) in the first 7 postoperative days, while the secondary outcomes were the associations between the VIS and 30-day and 1-year mortality, cardiovascular events in the first 30 days after OLTx, length of mechanical ventilation, and intensive care unit (ICU) length of stay. Design: Single-center retrospective observational study. Setting: Transplant center at a tertiary referral university hospital. Participants: One hundred forty-four patients who underwent OLTx between January 2018 and November 2023. Interventions: VIS evaluation in patients undergoing OLTx. Measurements and Main Results: Analysis showed that postoperative VIS correlated with the incidence of AKI (odds ratio [OR], 1.06; p = 0.03). Patients with VIS > 10 had a higher risk than patients with VIS < 5 (OR, 3.63; p = 0.006). VIS correlated with 30-day mortality (intraoperative: OR, 1.06 [p = 0.001]; postoperative: OR, 1.11 [p < 0.001]) and 1-year mortality (intraoperative: OR, 1.04 [p < 0.001]; postoperative: OR, 1.08 [p < 0.001]). In addition, VIS correlated with length of mechanical ventilation (intraoperative: R = 0.27 [p = 0.001]; postoperative: R = 0.36 [p < 0.001]) and ICU length of stay (intraoperative: R = 0.18 [p = 0.03]; postoperative: R = 0.21 [p = 0.01]). Conclusions: VIS calculated in the first 24 hours after OLTx showed a significant correlation with AKI in the first 7 postoperative days. VIS, calculated either intraoperatively or postoperatively, correlated with 30-day and 1-year mortality, duration of mechanical ventilation, and ICU length of stay.