PMID- 27496508
OWN - NLM
STAT- MEDLINE
DCOM- 20170426
LR  - 20170817
IS  - 1873-2623 (Electronic)
IS  - 0041-1345 (Linking)
VI  - 48
IP  - 5
DP  - 2016 Jun
TI  - Renal Artery Denervation in Patient After Heart and Kidney Transplantation With
      Refractory Hypertension.
PG  - 1858-60
LID - 10.1016/j.transproceed.2016.01.043 [doi]
LID - S0041-1345(16)00297-9 [pii]
AB  - We describe the case of a 54-year-old patient after renal and heart
      transplantation in whom uncontrolled hypertension was diagnosed. Despite combined
      antihypertensive therapy, no significant therapeutic effect was achieved.
      Clinical assessment of ambulatory blood pressure monitoring (ABPM) revealed the
      ineffectiveness of a bisoprolol, nitrendypin, klonidyn, ramipryl, furosemide, and
      doxasosine combination used at high doses. High blood pressure levels with their 
      effect on a hypertrophic transplanted heart (left ventricular mass 254 g) and
      poor renal graft function (39 mL/kg/min) posed an extremely high risk of future
      cardiovascular complications, and were the reason to perform a native renal
      arteries denervation. The procedure was carried out through the right femoral
      artery with the use of a 6F guiding catheter. During a 1-year observation,
      significant decreases in ABPM systolic and diastolic blood pressures were
      observed after the procedure (168/88 mm Hg vs 154/77 mm Hg, respectively).
      Moreover a significant regression of left ventricular mass (215 g/m(2)) and
      stable renal graft function were noted. The presented case shows that native
      renal arteries denervation may be successful and safe in kidney and heart
      transplant recipients. Moreover, during the 1-year follow-up, the reduction in
      blood pressure was followed by a reduction in transplanted heart hypertrophy,
      both leading to regression of cardiovascular risk for the patient.
CI  - Copyright (c) 2016 Elsevier Inc. All rights reserved.
FAU - Protasiewicz, M
AU  - Protasiewicz M
AD  - Department of Cardiology, Wroclaw Medical University, Wroclaw, Poland.
FAU - Banasik, M
AU  - Banasik M
AD  - Department of Nephrology and Transplantation Medicine, Wroclaw Medical
      University, Wroclaw, Poland. Electronic address: m.banasik@interia.pl.
FAU - Kurcz, J
AU  - Kurcz J
AD  - Department of Radiology, Wroclaw Medical University, Wroclaw, Poland.
FAU - Podgorski, M
AU  - Podgorski M
AD  - Department of Internal Disease and Hypertension, Wroclaw Medical University,
      Wroclaw, Poland.
FAU - Zembala, M
AU  - Zembala M
AD  - Department of Cardiac Surgery and Transplantology, SMDZ in Zabrze, Medical
      University of Silesia in Katowice, Silesian Centre for Heart Disease, Zabrze,
      Poland.
FAU - Zakliczynski, M
AU  - Zakliczynski M
AD  - Department of Cardiac Surgery and Transplantology, SMDZ in Zabrze, Medical
      University of Silesia in Katowice, Silesian Centre for Heart Disease, Zabrze,
      Poland.
FAU - Mysiak, A
AU  - Mysiak A
AD  - Department of Cardiology, Wroclaw Medical University, Wroclaw, Poland.
FAU - Boratynska, M
AU  - Boratynska M
AD  - Department of Nephrology and Transplantation Medicine, Wroclaw Medical
      University, Wroclaw, Poland.
FAU - Klinger, M
AU  - Klinger M
AD  - Department of Nephrology and Transplantation Medicine, Wroclaw Medical
      University, Wroclaw, Poland.
LA  - eng
PT  - Case Reports
PT  - Journal Article
PL  - United States
TA  - Transplant Proc
JT  - Transplantation proceedings
JID - 0243532
SB  - IM
MH  - Denervation
MH  - Female
MH  - *Heart Transplantation
MH  - Humans
MH  - Hypertension/physiopathology/*surgery
MH  - Kidney/*blood supply/physiopathology
MH  - *Kidney Transplantation/adverse effects
MH  - Male
MH  - Middle Aged
MH  - Renal Artery/physiopathology/*surgery
EDAT- 2016/08/09 06:00
MHDA- 2017/04/27 06:00
CRDT- 2016/08/07 06:00
PHST- 2015/12/30 00:00 [received]
PHST- 2016/01/21 00:00 [accepted]
PHST- 2016/08/07 06:00 [entrez]
PHST- 2016/08/09 06:00 [pubmed]
PHST- 2017/04/27 06:00 [medline]
AID - S0041-1345(16)00297-9 [pii]
AID - 10.1016/j.transproceed.2016.01.043 [doi]
PST - ppublish
SO  - Transplant Proc. 2016 Jun;48(5):1858-60. doi: 10.1016/j.transproceed.2016.01.043.