HYPERTENSION AFTER LUNG TRANSPLANTATION

Hypertension is a recognized side effect of cyclosporine administratio n after kidney, heart, and bone-marrow transplantation. The incidence has not been previously reported after lung transplantation. We review ed the incidence and potential causes of hypertension in recipients of single and double lung transplants. Twenty-one previously normotensiv e, stable recipients of lung transplants were reviewed retrospectively to determine the incidence of hypertension. Renal function as measure d by blood urea nitrogen, creatinine, prednisone, and cyclosporine lev els and dosages were determined at time of onset of hypertension. Hype rtension developed in 14 of 21 previously normotensive patients (66%) followed from 4 to 64 months after transplantation (mean onset 11 mont hs after transplantation). Renal function was diminished in all patien ts after transplantation. Neither the level of renal dysfunction nor c yclosporine dosage or level predicted the development of hypertension. The incidence of hypertension in lung transplant recipients was compa rable to that reported in cyclosporine-treated kidney transplant patie nts (67%) and bone-marrow transplant patients (60%) but was less than that in heart transplant recipients (90%). Preserved cardiac innervati on may explain the lower incidence of hypertension in lung compared wi th heart transplant recipients in the presence of comparable immunosup pressives and renal function. Time to onset of hypertension in lung tr ansplant recipients is delayed compared with that in other organ trans plants. This suggests that additional mechanisms as yet unexplored may be invoked.