PEDIATRICS

U.S. Bayrakci¹, E. Baskin¹, F. Ozcay², K. Gulleroglu¹, F. Ozbay hosnut³, S. Sevmis⁴, H. Karakayali⁴, M. Haberal^4
1Pediatric Nephrology, Baskent University, Ankara/TURKEY, ²Pediatric Gastroenterology, Baskent University, Ankara/TURKEY, ³Pediatric Gastroenterology, Hepatology And Nutrition, Ba?kent University Hospital, Ankara/TURKEY, ⁴General Surgery And Transplantation, Baskent University, Ankara/TURKEY

Body: Hypertension is a frequent cardiovascular risk factor in liver transplant recipients. However, there is not any data in the literature regarding the risk of hypertension in liver transplanted children. Aim: The aim of the this study was to assess the 24 h BP profiles of liver transplanted patients and to compare the results with healthy children Patients and method: ABPM was performed to 20 (M/F: 8/12) liver transplanted patients and 27 (M/F: 14/13) age and sex matched healthy children aged 6.5±5.2 and 8.7±2.6 years respectively. The mean duration of post-transplant follow-up was 32±19 months. Sixteen patients were receiving tacrolimus, 2 cyclosporin and 2 sirolimus during the study while, all of them had steroids and mycophenolate mofetil as a part of immunosuppressive protocol. Results: Eight (40%) patients found to be hypertensive and 65% of patients found to be non-dippers. Night time BP load was found to be elevated in 5 of them while, 3 of them were found to have high day time and night time BP loads. Number of subjects with high night time systolic (14.8±27.1) and diastolic BP load (29.8±35.1) as well as day time diastolic BP load (8.2±14.9) was found to be significantly higher in the study group (p=0.01, 0.03 and 0.03 respectively). Renal functions, the status of donor and immunosuppressive therapy seem to have no influence on the BP levels of patients. Conclusion: Alteration of the “normal” circadian rhythm is very frequent in liver transplant recipients which could be perceived as an early sign of future hypertension. Those patients should be handled with care and special instructions about life style and diet should be given in order to avoid future complications of hypertension. Thus, it is essential to perform ABPM in all transplanted subjects in order not to under diagnose hypertension in those patients.

Disclosure: All authors have declared no conflicts of interest.