<b>The Effect of Goal Directed Fluid Therapy in Renal Transplant Surgery on Post-Operative Outcome: A Retrospective Study</b>

Abstract Introduction: This study aimed to compare the effects of intraoperative conventional fluid therapy (CFT) using central venous pressure (CVP) guidance and goal-directed fluid therapy (GDT) using stroke volume variation (SVV) guidance on the incidence of delayed graft function (DGF) in renal transplant surgery. Methods: We retrospectively analyzed 179 patients who underwent renal transplant surgery at a single tertiary hospital. Patients were categorized into CFT and GDT groups. Patients in the CFT group were managed based on a target central CVP of 8-12 mmHg, while patients in the GDT group were managed by targeting an SVV of 10% within the preoperative baseline, apart from the target Mean arterial pressure (MAP) &gt;80 mmHg in both groups. Preoperative characteristics and intraoperative parameters were evaluated to determine their association with postoperative outcomes. Results: The GDT group showed a significant reduction in the incidence of postoperative DGF (p = 0.007), metabolic acidosis (p &lt; 0.001), cardiorespiratory complications (p = 0.011), ventilator dependency (p = 0.013), and length of ICU (p &lt; 0.001) and hospital stays (p &lt; 0.001). Conclusion: Goal-directed fluid therapy reduced the incidence of DGF, metabolic acidosis, cardiorespiratory complications, and ventilator dependency, and shortened intensive care unit (ICU) and hospital stays in renal transplant surgery. Keyword; Renal transplantations, goal directed therapy, delayed graft function, postoperative complications.