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Hypertension after pediatric cardiac transplantation: Detection, etiology, implications and management
Author(s) -
Roche S. Lucy,
O’Sullivan John J.,
Kantor Paul F.
Publication year - 2010
Publication title -
pediatric transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.457
H-Index - 69
eISSN - 1399-3046
pISSN - 1397-3142
DOI - 10.1111/j.1399-3046.2009.01205.x
Subject(s) - medicine , etiology , transplantation , intensive care medicine , heart transplantation , heart failure , pediatrics , cardiology
Roche SL, O’Sullivan JJ, Kantor PF. Hypertension after pediatric cardiac transplantation: Detection, etiology, implications and management.
Pediatr Transplantation 2010:14: 159–168. © 2009 Wiley Periodicals, Inc. Abstract: While it may rescue children with end‐stage heart failure from impending catastrophe, cardiac transplantation leaves 50–70% of pediatric recipients with new‐onset hypertension. Given the unique vulnerability of the heart and kidneys in these children, we can expect long‐term uncontrolled hypertension to shorten both graft and patient survival. In this review we discuss the multi‐factorial etiology of post‐transplant hypertension, highlighting current uncertainties and emphasizing mechanisms specific to cardiac recipients. We consider the optimal means of monitoring BP and in particular, the advantages of 24 h‐ABP over intermittent clinic measurements. We also review BP treatment after cardiac transplantation, drawing attention to specific cautions appropriate when prescribing antihypertensive agents in these circumstances.