LAUSR

The recent retrospective study by Goyal et al.[1] outlining the relationship between delayed graft function and pulmonary hypertension in patients undergoing renal transplantation addresses a number of potential responsible mechanisms for this relationship. For example, they suggest that haemodynamic instability (i.e. systemic hypotension) or deleterious circulating vasoactive substances can lead to poor perfusion and ischaemia of the transplanted kidney. Indeed, episodes of hypotension are not uncommon in the perioperative setting and patients with delayed graft functioning are also known to have higher levels of circulating endothelin-1, a potent vasoconstrictor that can lead to renal ischaemic injury,[2] in addition to pulmonary hypertension itself.[3]