Four cases of posttransplantation hypertension secondary to arterial stenosis in patients with relatively normal renal function occurred in 409 transplants or approximately 1% of the series. In two patients, renin levels were measured and were elevated. Three stenoses occurred on the donor side and one on the recipient side and could be traced to inclusion of previously clamped (or snared) vessels in the anastomosis in all but the last case. All four anastomoses were surgically corrected prior to ischemic damage to the graft.
Extreme care in resecting areas of vascular damage in both donor and recipient vessels prior to transplant anastomosis may prevent postoperative hypertension.