Severe hypertension and elevated plasma renin activity following transplantation of “hepatorenal donor” kidneys into anephric recipients

Post-Transplant Hypertension and Hypertensive Encephalopathy in Renal Allograft Recipients

“…In the immediate postoperative period the most com mon cause of hypertension is administration of large intra venous fluid volumes but other factors, such as residual pressor effects [5], acute thrombosis or stenosis of the allo graft artery [6], acute rejection [7,8], decreased perfusion of the native kidney [9], and high dose steroid therapy [10] may all be responsible. In one large series in children, the incidence of immediate post-transplant hypertension has been as high as 98% of 137 allograft recipients [3].…”

Hepatorenal Syndrome: Recent Insights and Therapy

“…The hepatorenal syndrome (HRS) is de fined as renal failure in patients with severely compromised liver function in the absence of clinical, laboratory or anatomic evidence of other known causes of renal failure [1], The functional nature of the HRS is obvious from the following considerations: (a) the labora tory findings in the blood and urine in HRS resemble extreme forms of prerenal failure with relatively preserved renal tubular func tion; (b) transplantation of normal liver into patients suffering from HRS may reverse the renal failure [2]; (c) kidneys taken from pa tients who had died of HRS may function normally following transplantation into re cipients with normal liver [3,4]; (d) angio graphic renal vasoconstrictor patterns seen during life in patients with HRS disappear on post mortem angiography of such kidneys [5,6] and (e) in most patients with HRS, the kid ney histology is normal. Thus, in classic HRS, there is advanced liver failure with mild to moderate azotemia of the prerenal type.…”

Plasma renin activity following renal transplantation

“…During acute rejection episodes a close correlation has been found between plasma renin activity (PRA) and blood pressure (Popovtzer et al, 1973) acute hypertension has occurred after the transplantation of 'high renin' allografts from donors with hepato-renal syndrome into anephric recipients (MacDonald, Brennan and Turcotte, 1973).…”