Evaluation of arterial hypertension by ambulatory blood pressure monitoring in pediatric liver transplant recipients

Arikanoğlu, Emrullah; Tabel, Yılmaz; Selimoğlu, Ayşe

doi:10.1097/mbp.0000000000000563

Cited by 6 publications

(3 citation statements)

References 22 publications

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“…The reported incidence of hypertension in pediatric liver transplant patients varies from 10% to 60%, depending on the methods and definitions used. 37,38 In a single-center study by Lund et al 39 after a median follow-up period of 19 years, 31.7% of young adults post liver transplant were hypertensive. The pathophysiology of post-transplant hypertension is multifactorial and can be subdivided into the pre-transplant era, the allograft implantation in the case of combined liver and kidney transplantation and the post-transplant era.…”

Section: Incidence and Etiologymentioning

confidence: 99%

“…The reported incidence of hypertension in pediatric liver transplant patients varies from 10% to 60%, depending on the methods and definitions used 6–29,37,38 . In a single‐center study by Lund et al 39 .…”

Section: Post‐transplant Hypertension: Incidence Etiology Mechanisms ...mentioning

confidence: 99%

“…Hypertension is a well‐known side effect of tacrolimus 6–29,37,38 . The physiological pathways involved in tacrolimus‐induced hypertension are summarized in Table 1.…”

Section: Post‐transplant Hypertension: Incidence Etiology Mechanisms ...mentioning

confidence: 99%

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Etiology, risk factors and management of hypertension post liver transplantation

Braekman,

De Bruyne,

Vandekerckhove

et al. 2023

Pediatric Transplantation

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BackgroundCardiovascular events are one of the most important causes of morbidity and mortality in the long‐term follow‐up of liver transplant recipients. Hypertension is a significant cardiovascular risk factor that occurs frequently after pediatric liver transplantation. Chronic use of immunosuppressants – mainly calcineurin inhibitors – plays a major role in the development of post‐transplant hypertension and circadian disturbances such as flattening of the nocturnal blood pressure dip. This requires special attention in children given the long timeframe during which immunosuppressive therapy is necessary. Careful and structured blood pressure monitoring and adequate treatment of hypertension are essential to optimize the quality of life and life expectancy of pediatric liver transplant patients. However, evidence‐based guidelines for monitoring and management of post‐transplant hypertension and its complications are lacking.MethodsWe conducted a comprehensive review of the current knowledge and practices concerning post‐transplant hypertension. The databases Pubmed, Embase, Web of Science and Google Scholar were scanned with the following keywords: pediatric liver transplantation, immunosuppression, tacrolimus, cardiovascular effects, hypertension, heart function, kidney function, circadian rhythm, mechanism, monitoring, and management.ResultsIn this review, we describe the incidence and etiology of hypertension in pediatric liver transplant recipients, the underlying mechanisms and characteristics of calcineurin inhibitor‐induced hypertension, and the consequences of and risk factors for post‐transplant hypertension. We hereby present an overview of the current practices in blood pressure monitoring and antihypertensive treatment as well as an algorithm for the evaluation and management of hypertension post liver transplantation. Finally, we discuss knowledge gaps and suggestions for future research.

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Section: Incidence and Etiologymentioning

confidence: 99%

Section: Post‐transplant Hypertension: Incidence Etiology Mechanisms ...mentioning

confidence: 99%