Prevalence and Time of Development of Systemic Arterial Hypertension in Patients After Liver Transplantation

Abstract

BACKGROUND: The use of immunosuppressive drugs after liver transplantation (LT) is associated with the development of systemic arterial hypertension (SAH), in addition to other comorbidities of metabolic syndrome. OBJECTIVE: Therefore, the purpose of this study was to analyze the time after use immunosuppressive drugs the patient progresses to SAH, as well as to identify its prevalence and the factors that may be correlated to it. METHODS: A retrospective and longitudinal study was conducted, based on the analysis of medical records of 72 normotensive patients, attended in the transplant unit of a university hospital, between 2016 and 2019. RESULTS: It was observed, on average, 9±6.98 months after immunosuppressive use, the patients were diagnosed with hypertension, and the prevalence of transplanted patients who evolved to SAH in this study was 59.64% (41 patients). In addition, there was a correlation between serum dosage of tacrolimus and the development of SAH (P=0.0067), which shows that tacrolimus has a significant role in the development of SAH. Finally, it was noticed that the development of post-transplantation hypertension indicates a higher risk of the patient presenting the other parameters of metabolic syndrome, as well as a higher impairment in its renal function (P=0.0061). CONCLUSION: This study shows that the patients evolved to SAH in an average of 9±6.98 months after immunosuppressive drug use. We have also found high prevalence of systemic arterial hypertension (59.64%) in patients after liver transplantation, who used calcineurin inhibitors, especially when associated with the use of tacrolimus.

Metabolic Disorders in Liver Transplant Recipients: The State of the Art

“…While arterial hypertension is one of the most prevalent cardiovascular risk factors in the general population, the incidence of post-liver transplantation hypertension is remarkably high, ranging between 50% and 80%, as reported by some studies [4,18,19]. The onset of de novo arterial hypertension post liver transplantation, as reported in a study conducted by de Oliveira Lemos et al [20], occurred at an average of 9 ± 6.98 months. The prevalence of arterial hypertension significantly increases in liver transplant recipients, ranging from 21% to 56% [21][22][23][24].…”

Prevalent Complications in Heart Transplantation: A Retrospective Cohort Analysis

“…Among those unrelated to the graft, we find infections, reactivation of Chagas disease (CD), renal dysfunction, neoplasia, diabetes mellitus (DM), and systemic arterial hypertension (SAH), among others 5 . Studies show that the association of calcineurin inhibitors is related to the incidence of hypertension, with cyclosporine being more associated when compared to tacrolimus 6 . Other studies carried out with post-kidney transplant patients state that immunosuppression is a risk factor for the emergence of DM after transplantation, especially corticosteroids and tacrolimus, the latter being more associated with this pathology when compared to cyclosporine 7 .…”

Complicações Prevalentes no Transplante Cardíaco: Uma Análise de Coorte Retrospectiva

“…Dentre as não relacionadas ao enxerto, encontramos as infecções, a reativação da doença de Chagas (DC), a disfunção renal, neoplasia, diabetes mellitus (DM), hipertensão arterial sistêmica (HAS), entre outras 5 . Estudos mostram que a associação de inibidores da calcineurina está relacionada com a incidência de HAS, sendo a ciclosporina mais associada quando comparada ao tacrolimus 6 . Outros estudos realizados com pós-transplantados renais afirmam que a imunossupressão é fator de risco para o surgimento de DM após o transplante, principalmente os corticosteroides e tacrolimus, sendo esse último mais associado a essa patologia quando comparado à ciclosporina 7 .…”