Abstract
We describe the radiographic imaging modalities that were used in the first twelve consecutive patients who have undergone simultaneous pancreas and kidney transplantation (SPK) at our institution. The total number of examinations undertaken in this study included ultrasound (n=22), radionucleide scanning (n=19), cystography (n=14), computed tomography (n=2) and magnetic resonance imaging (n=l). Eighteen percent (5/22) ultrasound examinations were abnormal (perirenal collection [n=4], peri-pancreatic collection [n=l]). Two collections required aspiration and were confirmed as lymphocoeles. Cystography showed ureteric reflux in two patients and radionucleide DTPA scanning revealed a delay in the excretory phase in 20% of patients. CT was used in two patients with SPK and demonstrated large peri-pancreatic collections. No episodes of rejection or late graft pancreatitis were noted in this series.
We discuss the role of radiographic imaging in detecting early graft failure and also in defining the surgical complications that may arise following transplantation. We also outline the merits and disadvantages of each imaging modality. We conclude that the most useful initial imaging techniques in the evaluation of patients following SPK are ultrasound including Doppler and nuclear medicine.
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Bilous, R. W., Maurer, S. M., Sutherland, D. R. et al. The effects of pancreatic transplantation on the glomerular structure of renal allografts in patients with insulin dependent diabetes. N. Engl. J. Med. 1989; 321: 80–5.
Ramsey, R. C., Goetz, F. C., Sutherland, D. R. et al. Progression of diabetic retinopathy after pancreatic transplantation for insulin dependent diabetes. N. Engl. J. Med. 1988; 318: 208–14.
Kennedy, W. R., Navarro, X., Goetz, F. C. et al. Effects of pancreatic transplantation in diabetic neuropathy. N. Engl. J. Med. 1990; 322: 1031–37.
Sollinger, H. W., Geffner, S. R. Pancreas transplantation. Surg. Clin. N. Amer. 1994; 74: 1183–95.
Letourneau, J., Day, D., Feinberg, S. Ultrasound and computed tomograpic evaluation of renal transplantation. Rad. Clin. N. Amer. 1987; 25(2): 267–78.
Gilabert, R., Bru, C., Ricart, M. J., Astudillo, E., Saenz, A., Llovera, J. M., Lopez-Boado, M. A., Sanfey, H., Fernandez-Cruz, L. Pancreatic transplant rejection: evaluation by Duplex-Doppler ultrasound with urinary amylase monitoring correlation. Transplantation Proceedings 1992; 24(1): 11.
Ngheim, D., Ludrosky, L., Young, J. Evaluation of pancreatic circulation by duplex color flow sonography. Transplant Proc. 1994; 26: 2: 466.
Shulkin, B., Dafoe, D., Wahl, R. Simultaneous pancreaticrenal transplant scintigraphy. AJR 1986; 147: 1193–6.
Stratta, R., Sollinger, S., Perlman, S., D’allesandro, A., Groshek, M., Kalayoglu, M., Pirsch, J., Belzer, F. Early detection of rejection in pancreatic transplantation. Diabetes 1989; 38(1): 63–7.
Lund, G., Letourneau, J., Day, D., Crass, J. MRI in organ transplantation. Rad. Clin. N. Amer. 1987; 25(2): 281–7.
Secchi, A., Sironi, S., La Rocca, E., Caldara, R., Di Carlo, V., Martinenghi, C., Staudacher, C., Pozza, G. Magnetic resonance imaging after pancreas and kidney transplantation. Transplant Proc. 1990; 22(4): 1603–4.
Yuh, W., Wiese, J., Abu-Yousef, M., Rezai, K., Sato, Y., Betbaum, K., Kao, S., Hunsicker, L., Corry, R. Pancreatic transplantation imaging. Radiology 1988; 167: 679–83.
Kelez, F., Sollinger, H. W., Pirsch, J. D. MRI of the pancreas transplant: lack of correlation between imaging and clinical status. Mag. Res. Med. 1991; 21(1): 30–8.
Svahn, T., Lewander, R., Hardstedt, C., Lundgren, G., Sundelin, P., Groth, C. G. Angiography and scintigraphy of human pancreas allografts. Acta Radiol. 1977; 19: 297–304.
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Stafford Johnson, D.B., Keeling, F., McGrath, F. et al. Radiologic evaluation of simultaneous pancreas-kidney transplantation. I.J.M.S. 165, 105–108 (1996). https://doi.org/10.1007/BF02943794
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DOI: https://doi.org/10.1007/BF02943794