Role of sonography in pancreatic transplantation

Despite recent advancements in surgical technique and immunosuppressive therapy, postoperative complications of pancreatic transplantation are still common. A complex spectrum of such adverse events includes graft rejection, peripancreatic fluid collections, pancreatitis, exocrine leaks, vascular thrombosis, and hemorrhage. Sonography plays a key role in the initial evaluation of the transplanted pancreas. Gray-scale sonography, duplex Doppler imaging, and sonographic guidance for percutaneous biopsy all contribute to posttransplantation evaluation and detection of sequelae. Color and power Doppler imaging offer valuable information regarding the regional vasculature and potential vascular complications. Because gray-scale sonographic findings alone are often nonspecific, several clinical criteria, including those from biochemical analysis of the urine and serum, must be reviewed with the sonographic findings to provide a thorough evaluation of the transplanted pancreas. When used in conjunction with serologic and urinary markers, the findings from sonography can help direct management options or suggest the need for further examination. Therefore, an understanding of the spectrum of complications combined with knowledge concerning the limitations of this imaging modality are essential for proper diagnosis and effective treatment.