Document Detail


Resolution of posttransplant hypertension after liver transplantation despite impaired glomerular filtration.
MedLine Citation:
PMID:  7873733     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Hypertension developing after transplantation is characterized by widespread vasoconstriction including the kidney. Late resolution (mean, 29 +/- 4 months) of posttransplant hypertension has been observed in 15 (Group I) of 278 subjects monitored after liver transplantation. These studies were undertaken to define the systemic and renal changes associated with resolution, as compared with a group matched for age, sex, and time after transplant who remained hypertensive (Group II; N = 15) or a group who never developed hypertension (Group III; N = 23). Blood pressure during resolution paralleled changes in the systemic resistance index, which fell from 3,052 +/- 548 to 1,872 +/- 205 dyne/s.cm5/m2 (P < 0.01). GFR and RBF remained low, despite the resolution of hypertension, and renal vascular resistance did not change. Circulating endothelin levels remained above normal in all transplant recipients (Group I, 11.9 +/- 3.0 versus normal subjects, 7.0 +/- 1.1 pg/mL; P < 0.05), and urinary prostacyclin excretion was suppressed (880 +/- 120 versus 2,247 +/- 187 ng/day; P < 0.01). No hormonal differences were apparent between transplant groups. These results demonstrate the capacity for systemic vasodilation to occur after transplantation, independent of vascular tone in the kidney. They further suggest that renal vasoconstriction and impaired GFR alone are not sufficient to explain de novo hypertension after transplantation.
Authors:
S C Textor; L Schwartz; V J Canzanello; R Wiesner; S J Taler; M Porayko; D J Wilson; R Krom; J C Burnett; J C Romero
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Journal of the American Society of Nephrology : JASN     Volume:  5     ISSN:  1046-6673     ISO Abbreviation:  J. Am. Soc. Nephrol.     Publication Date:  1994 Nov 
Date Detail:
Created Date:  1995-04-06     Completed Date:  1995-04-06     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  9013836     Medline TA:  J Am Soc Nephrol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1223-30     Citation Subset:  IM    
Affiliation:
Department of Medicine, Mayo Clinic, Rochester, MN 55905.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aldosterone / blood
Antihypertensive Agents / therapeutic use
Epoprostenol / urine
Female
Glomerular Filtration Rate*
Hemodynamics
Humans
Hypertension / drug therapy,  etiology*,  physiopathology*
Liver Transplantation*
Male
Middle Aged
Postoperative Complications*
Renal Circulation
Renin / blood
Grant Support
ID/Acronym/Agency:
MO1-RR-585/RR/NCRR NIH HHS
Chemical
Reg. No./Substance:
0/Antihypertensive Agents; 35121-78-9/Epoprostenol; 52-39-1/Aldosterone; EC 3.4.23.15/Renin

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