Rangganata E, Castellanos De Brigard J, Prionas A, Habib N, Papalois VE. Total intravenous anesthesia in kidney transplantation: A narrative review. World J Transplant 2026; 16(3): 121739 [DOI: 10.5500/wjt.121739]
Corresponding Author of This Article
Ervandy Rangganata, MD, Department of Surgery and Cancer, Imperial College London, Du Cane Road, London W12 0HS, United Kingdom. e.rangganata24@imperial.ac.uk
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Medicine, Research & Experimental
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Rangganata E, Castellanos De Brigard J, Prionas A, Habib N, Papalois VE. Total intravenous anesthesia in kidney transplantation: A narrative review. World J Transplant 2026; 16(3): 121739 [DOI: 10.5500/wjt.121739]
World J Transplant. Sep 18, 2026; 16(3): 121739 Published online Sep 18, 2026. doi: 10.5500/wjt.121739
Total intravenous anesthesia in kidney transplantation: A narrative review
Ervandy Rangganata, Juanita Castellanos De Brigard, Apostolos Prionas, Nagy Habib, Vassilios E Papalois
Ervandy Rangganata, Juanita Castellanos De Brigard, Apostolos Prionas, Nagy Habib, Vassilios E Papalois, Department of Surgery and Cancer, Imperial College London, London W12 0HS, United Kingdom
Author contributions: Rangganata E conceived the review, performed the literature search, drafted the manuscript, and led the response to peer review; Castellanos De Brigard J performed the second independent screening and quality appraisal and contributed to the discussion of immunologic implications; Prionas A provided third-reviewer adjudication on study selection and critically reviewed the manuscript; Habib N contributed to the interpretation of mechanistic and surgical-technique aspects; Papalois VE supervised the project, contributed to the framing of clinical priorities, and approved the final manuscript; and all authors approved the submitted and revised versions.
AI contribution statement: The authors take full responsibility and accountability for all content of this manuscript, including any portions for which AI tools were used as assistive technologies. All AI-assisted outputs were carefully reviewed, validated, and approved by the authors. AI tools were not used to generate original scientific data, perform independent scientific analyses, or draw scientific conclusions.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest, financial or otherwise, relevant to the content of this manuscript. No author has any financial relationship with manufacturers of propofol, volatile anaesthetic agents, target-controlled infusion equipment, or any other product or service discussed in this review. This work received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Corresponding author: Ervandy Rangganata, MD, Department of Surgery and Cancer, Imperial College London, Du Cane Road, London W12 0HS, United Kingdom. e.rangganata24@imperial.ac.uk
Received: March 31, 2026 Revised: June 30, 2026 Accepted: July 27, 2026 Published online: September 18, 2026 Processing time: 151 Days and 19.3 Hours
Core Tip
Core Tip: This narrative review compares propofol-based total intravenous anaesthesia (TIVA) with volatile anaesthesia in adult kidney transplantation. Across six comparable studies, TIVA delivers haemodynamic stability and graft function equivalent to volatile maintenance, with reproducible advantages in extubation time and postoperative nausea and vomiting—the latter clinically important for reliable early enteral absorption of immunosuppressants. The biomarker signal of reduced tubular stress under propofol from the VAPOR-1 trial has not translated into measurable clinical benefit in low-risk living-donor cohorts. The next critical step is an adequately powered multicentre randomised trial in extended-criteria-donor and donation-after-circulatory-death recipients, with standardised opioid, fluid, and vasopressor protocols.
