Faculty Collaboration Database

Pancreas transplant imaging: how I do it. Radiology 2015 Apr;275(1):14-27

Date

03/24/2015

Pubmed ID

25799333

DOI

10.1148/radiol.15131585

Scopus ID

2-s2.0-84926429543 (requires institutional sign-in at Scopus site)   34 Citations

Abstract

Pancreas transplantation aims to restore physiologic normoglycemia in diabetic patients with glomerulopathy and avoid or delay the onset of diabetic retinopathy and arteriopathy. Simultaneous pancreas-kidney transplant is the most common approach, using a cadaveric pancreas donation in conjunction with either cadaveric or live donor renal transplant. Alternative techniques include pancreas after kidney transplant, in which the pancreas transplant is performed some years after renal transplant. Pancreas transplant alone is utilized rarely in diabetic patients with compensated renal function. Pancreas grafts have vascular and enteric connections that vary in their anatomic approach, and understanding of this is critical for imaging with ultrasonography, computed tomography, or magnetic resonance imaging. Imaging techniques are directed to display the pancreatic transplant arterial and venous vasculature, parenchyma, and intestinal drainage pathway. Critical vascular information includes venous thrombosis (partial or complete), arterial occlusion, or aneurysm. Parenchymal abnormalities are nonspecific and occur in pancreatitis, graft rejection, and subsequent graft ischemia. Peripancreatic fluid collections include hematoma/seroma, pseudocyst, and abscess. The latter two are related to pancreatitis, duct disruption, or leak from the duodenojejunostomy. An understanding of transplant anatomy and complications will lead to appropriate use of imaging techniques to diagnose or exclude important complications.

Author List

Tolat PP, Foley WD, Johnson C, Hohenwalter MD, Quiroz FA

Author

Parag P. Tolat MD Chief, Associate Professor in the Radiology department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Diagnostic Imaging
Humans
Pancreas
Pancreas Transplantation
Postoperative Complications
Tissue and Organ Procurement