Ngwa T, Orman E, Gomez EV, et al. - Among patients with cirrhosis who were referred for liver transplantation between January and June 2012, researchers characterized the use and impact of non-selective beta-blockers (NSBB). Of 170 consecutive individuals assessed for liver transplantation during the study period, 65 were using NSBB at the time of initial evaluation, involving 36 on propranolol, 19 on nadolol and 10 on carvedilol. According to this single-center cohort, there was a higher MELD and Child Pugh score for patients taking NSBB. An association was found between NSBB use and lower 90-day mortality with a risk adjusted hazard ratio of 0.27. Patients taking NSBB experienced more frequent acute kidney injury (AKI) than patients not taking NSBB within 90 days. This was, however, linked to increased stage 1 AKI episodes, all of which resolved. The discontinuation of the NSBB was common and was primarily due to hypotension and stage 1 AKI. The authors concluded that NSBB use is related to better short-term survival in patients with cirrhosis undergoing liver transplant evaluation. Nevertheless, in this population, the ongoing tolerance of NSBB is dynamic and can select a subset of patients with better hemodynamic reserve.