Late hypertension in renal transplant recipients: possible role of the donor in late primary hypertension.

Late onset (3-7 yrs) post-transplant renal hypertension is usually an indication of chronic, irreversible renal damage, and is a poor prognostic sign. In a small percent of patients (10%) however, hypertension can persist for years in conjunction with excellent renal function, and the absence of any known causes of early or late hypertension. This primary hypertension does not seem related to the recipient's pre-transplant blood pressure nor to the original renal disease. Rather, the high incidence of essential hypertension in the respective living related donor suggests that either a hypertensive diathesis exists, common to donor and recipient, or a transplantable factor inherent to the graft, or both causes, predispose to late onset primary hypertension.