Abstract: Objective To analyze the impact of perioperative terlipressin on bleeding and postoperative renal function following liver transplantation. Methods A retrospective analysis was performed on 236 patients who underwent liver transplantation at our hospital from September 2020 to September 2022. Patients were divided into two groups based on whether they received a continuous intraoperative terlipressin infusion: the terlipressin group and the control group. Clinical data from both intraoperative and postoperative periods were compared using propensity score matching to balance preoperative variables. Results Among the 224 patients included in the subgroup analysis, acute kidney injury occurred in 87 (38.8%) individuals. Using 1:1 propensity score matching, 89 patients who received perioperative terlipressin were matched with 69 control patients In the terlipressin group (n=69), 25 patients (36.2%) developed acute kidney injury, which was lower than the 30 patients(43.5%) in the control group (n=69). However, there was no statistical difference between the two groups (P>0.05). There was also no significant difference in perioperative bleeding and blood transfusion rates between the two groups (P>0.05). The perioperative urine volume in the terlipressin group was significantly higher[median: 1250ml, interquartile range: 875 mL-1750 mL] compared to the control group [median: 950ml, interquartile range: 565 mL-1450 mL](P<0.05). For severe acute kidney injury, the terlipressin group had fewer instances(3 cases, 4.3%) compared to the control group(12 cases, 17.4%) (P<0.05). Conclusion Continuous infusion of terlipressin during the perioperative period can significantly enhance perioperative urine output and may potentially reduce the incidence of severe acute kidney injury.

Key words: Terlipressin, Liver transplantation, Renal function, Acute kidney injury, Propensity score matching