Angiotensin-converting enzyme-induced angioedema occurs in 0.1-0.7 % of recipients. Swelling often affects head and neck and makes it an extremely dangerous adverse effect.
Bradykinin is considered to be the main mediator of edema in these cases. There is currently no specific treatment for angioedema of this etiology.
Drugs used for treatment of attacks in hereditary angioedema with C1 inhibitor deficiency are tried also in this indication, but there are currently no clinical studies available supporting their effectiveness. Patients using angiotensin-converting enzyme inhibitors with angioedemas of unknown etiology must discontinue using this drug.
Swelling episodes may appear even after this arrangement.