Evaluation of hypertension in children with liver transplantation by the ambulatory blood pressure monitoring method (ABPM)

Evaluatıon Of Hypertensıon In Chıldren With Lıver Transplantatıon By The Ambulatory Blood Pressure Monıtorıng Method (ABPM) Objectives: To determine the frequency of arterial hypertension, which is known as a risk factor after liver transplantation, and to identify these patients at an early stage and contribute to the initiation of appropriate treatments and prevention of permanent organ damage. Material and Methods: In this study; It was planned prospectively on 36 patients, aged between 8-17, who applied to İnönü University Faculty of Medicine Department of Pediatric Health and Diseases 'Pediatric Hepatology Outpatient Clinic for control purposes and had liver transplantation. Office blood pressure, height, weight, and measurements were made during the application of the patients to the outpatient clinic. Patient files were examined age, gender, VKİ, blood electrolytes, urea, creatinine, albumin, uric acid, AST, ALT, hemogram, and complete urine tests were recorded. 24-hour blood pressure measurements were performed by ambulatory blood pressure monitoring (ABPM) method. Statistical analysis was performed using SPSS (Statististical Program in Social Sciences) 22.0 software program. Results: Of the 36 liver transplant patients included in our study, 20 (55.6%) were male and 16 (44.4) were female, the mean age of the patients was 12.42±2.74 years and their average weight was 43.11±14.79 kg, mean height 147.31±16.39 cm, VKİ averages 19.23±3.54. Hypertension was found in 47.2% of the cases according to the blood pressure values obtained by ambulatory blood pressure monitoring method. 58.8% of the hypertensive cases were found to be male and 41.2% to female. While 1 (2.7%) patient was hypertensive when measuring with office blood pressure, 17 (47.2%) patients were found to be hypertensive when measured with ABPM. The mean VKİ of the patients with hypertensive ABPM results were found to be significantly higher than the patients with normotensive. The mean diastolic blood pressure values of the hypertensive patients were found to be statistically significantly higher. At the same time, the rate of isolated nocturnal hypertension was found to be high. Non-dipper hypertension was detected in 88.2% of patients whose ABPM result was hypertensive. The median time of ABPM implantation after transplantation was found to be 2 years, and more hypertension was found in patients with ABPM in the first two years, but no statistically significant relationship was found with the duration. Conclusion: The high prevalence of hypertension in this study in pediatric liver transplant patients draws attention to the importance of blood pressure measurement during routine health checks. In our study, it has been shown that office blood pressure measurement method is not sufficient in blood pressure monitoring, and ABPM is more sensitive in the diagnosis and treatment of hypertension in patients who have undergone liver transplantation. As a result of this study, it shows that early diagnosis can be made by using ABPM in pediatric liver transplant patients and it can prevent long-term complications by controlling hypertension in the early period. Keywords: Ambulatory blood pressure monitoring, Child, Hypertension, Liver transplant