High Prevalence of Hypertension and Alterations in Rhythmicity in Recipients of Pediatric Transplants

N. Memaran,¹ M. Kirchner,² R. Blöte,¹ B. Maecker-Kolhoff,³ I. Goldschmidt,¹ C. Müller,⁴ J. Epping,⁵ R. Sugianto,¹ B. Borchert,¹ B. Schmidt,⁶ E. Wühl,⁷ A. Melk.¹

¹Department of Pediatric Kidney, Liver and Metabolic Diseases, Hannover Med. School, Hanover, Germany
²Department of Medical Biometry, University of Heidelberg, Heidelberg, Germany
³Department of Pediatric Hematology and Oncology, Hannover Med. School, Hanover, Germany
⁴Department of Pediatric Pulmonology, Allergology, and Neonatology, Hannover Med. School, Hanover, Germany
⁵Department of Medical Sociology, Hannover Med. School, Hanover, Germany
⁶Department of Nephrology and Hypertension, Hannover Med. School, Hanover, Germany
⁷Division of Pediatric Nephrology, University Children's Hospital, Heidelberg, Germany.

Meeting: 2018 American Transplant Congress

Abstract number: B285

Keywords: Pediatric, Post-transplant hypertension

Topic:

Session Information

Session Name: Poster Session B: Liver: Pediatrics

Date: Sunday, June 3, 2018

Session Time: 6:00pm-7:00pm

Presentation Time: 6:00pm-7:00pm

Location: Hall 4EF

Hypertension (HTN) is a major issue after transplantation (Tx). Ambulatory blood pressure (BP) monitoring (ABPM) permits the diagnosis of masked HTN and nocturnal HTN. Fourier analysis allows the characterization of BP rhythmicity. Our aim was to describe the prevalence of HTN in ped. liver (LiT), lung (LuT), stem cell (ScT), and renal tx (RT) recipients and to assess changes in rhythmicity in a case-control study. We prospectively assessed 172 patients (50% male; mean age 13±4 years) after LuT (n=36), LiT (n=46), ScT (n=44), and RT (n=46) Tx, and matched patients 1:3 for age and gender with a healthy cohort (n=516).

HTN affected almost all patients after RT (96%) and was also highly prevalent in patients after LuT (86%), LiT (39%) and ScT (26%). The frequency of untreated HTN was higher in the non-renal patients. Masked and nocturnal HTN were highest in LuT recipients. Of note, in 48%, 67%, and 73% of all hypertensive LuT, LiT, and ScT patients hypertension was only detected by ABPM. Significant alterations in rhythmicity were seen in all cohorts, characterized by an increased mesor and an delayed 24-h-acrophase, whereas the 24-h-amplitude remained unchanged or even decreased. ABPM screening therefore is mandatory in transplanted children for diagnosing HTN. The underlying mechanisms of post-transplant hypertension are associated with an altered circadian rhythm.

CITATION INFORMATION: Memaran N., Kirchner M., Blöte R., Maecker-Kolhoff B., Goldschmidt I., Müller C., Epping J., Sugianto R., Borchert B., Schmidt B., Wühl E., Melk A. High Prevalence of Hypertension and Alterations in Rhythmicity in Recipients of Pediatric Transplants Am J Transplant. 2017;17 (suppl 3).

To cite this abstract in AMA style:

Memaran N, Kirchner M, Blöte R, Maecker-Kolhoff B, Goldschmidt I, Müller C, Epping J, Sugianto R, Borchert B, Schmidt B, Wühl E, Melk A. High Prevalence of Hypertension and Alterations in Rhythmicity in Recipients of Pediatric Transplants [abstract]. https://atcmeetingabstracts.com/abstract/high-prevalence-of-hypertension-and-alterations-in-rhythmicity-in-recipients-of-pediatric-transplants/. Accessed July 30, 2021.

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