Pathogenesis of post-transplant hypertension is complex and involve in the interplay between donor's and recipient's factors. Kidneys from non-hypertensive donors may be one of these main factors.Design and Method:
A total of 94 kidney and/or liver-kidney transplantations from January 2015 to March 2016 were reviewed. There were 10 kidney transplant recipients who received paired deceased donor kidneys (derived from the same donor transplanted to different recipients) leading to 5 “mate” recipient pairs.Results:
Of all 10 recipients, mean age was 55 years old (41–63 years old) and 7 of these were male. Mean duration of follow-up was 5.4 months (1–10 months). Up to 90% of recipients had pre-transplant hypertension. Mean post-transplant systolic blood pressure (SBP) was lower than mean pre-transplant SBP but not statistically significant (134+/−7.83 vs. 142+/−5.79, p= 0.4221) as same as mean DBP (73+/−4.43 vs. 79+/−3.51, p = 0.3349) (Table 1). Mean age of kidney donors were 42 years old (27–55 years old) and 80% were male. Up to 80% were donation after circulatory death (DCD) kidneys with an average Kidney Donor Profile Index (KDPI) of 69.4%. Donors with a history of hypertension were account for 60%. Nine out of ten recipients had pre-transplant hypertension. One non-hypertensive recipient continued to be non-hypertensive after transplantation. For the remaining 9 patients, 6 recipients became non-hypertensive after kidney transplantation, which was defined as SBP ≤ 140, DBP ≤ 90, or being on ≤ 2 BP agents regardless SBP or DBP (Figure 1A). All mate recipients receiving non-hypertensive kidneys had no post-transplant hypertension; whereas, only two third of the mate recipients receiving hypertensive kidneys became non-hypertensive post-transplantation (Figure 1B).Conclusions:
Kidney transplantation can improve or resolve hypertension in pre-transplant hypertensive recipients particularly utilizing kidneys from non-hypertensive donors. Since hypertension may persist in mate recipients receiving hypertensive kidneys, other recipient factors may play a more important role in the pathogenesis of post-transplant hypertension.