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Multirow CT in the follow-up of pancreas transplantation
1Division of Diagnostic and Interventional Radiology, University of Pisa, Pisa, Italy. neri@med.unipi.it
Insights
Multirow CT effectively monitors patients after pancreas or kidney-pancreas transplants, identifying crucial complications like graft thrombosis and infections for better patient outcomes.
Area of Science:
- Transplantation Surgery
- Radiology
- Endocrinology
Background:
- Pancreas transplantation offers a definitive solution for type 1 diabetes mellitus.
- Monitoring post-transplant complications is vital for patient survival and graft function.
Purpose of the Study:
- To evaluate the utility of multirow computed tomography (CT) in the follow-up of patients undergoing pancreas or combined kidney-pancreas transplantation.
- To assess the capability of multirow CT in detecting surgical techniques and post-operative complications.
Main Methods:
- Thirty patients (13 isolated pancreas, 17 kidney-pancreas) with systemic-bladder or enteric-portal drainage were studied.
- Multirow CT protocols included specific phases (unenhanced, arterial, portal, urographic) and thoracic scans when indicated.
- Detailed CT acquisition parameters (1.25-mm collimation, 0.6-mm reconstruction, pitch 6) were employed.
Main Results:
- Multirow CT successfully identified the surgical techniques used for pancreatic drainage.
- The modality visualized the transplanted pancreas and detected various complications, including arterial/venous graft thrombosis, anastomosis dehiscence, and abdominal collections.
- Pulmonary infections were also identified in relevant cases.
Conclusions:
- Multirow CT is a valuable tool for the follow-up of pancreas and kidney-pancreas transplant recipients.
- Its ability to detect diverse complications aids in timely management and improves patient care post-transplantation.
Purpose:
Isolated pancreas or combined kidney-pancreas transplantation represents the only therapeutic weapon for complete resolution of type I diabetes mellitus. The purpose of the present study was to investigate the role of multirow CT in the follow-up of these patients.
Materials And Methods:
Thirty patients who underwent isolated (n = 13) or combined kidney-pancreas (n = 17) transplantation, using systemic-bladder (n = 7) or enteric-portal (n = 23) drainage, were evaluated with multirow CT (Light Speed Plus, GE Medical System). The CT study included unenhanced, arterial, and portal phases of the isolated pancreas, and a urographic phase for combined kidney-pancreas transplants. The acquisition was done with 1.25-mm collimation, 0.6-mm reconstruction interval, and a pitch of 6. A CT scan of the thorax was included if patients were suspected to have pulmonary complications.
Results:
In all cases it was possible to recognize the surgical technique performed for endocrine and exocrine pancreatic drainage, to evaluate the transplanted pancreas, and to identify possible complications. For example, CT identified thrombosis or stenosis of the arterial graft, partial thrombosis of the venous graft, ectasia of the common iliac artery and arterial graft, dehiscence of the duodenal-bladder anastomosis, infected abdominal collections, thrombosis of the internal iliac vein, and pulmonary infections.
Conclusions:
Because multirow CT detects complications it is useful to follow isolated pancreas or combined kidney-pancreas transplants.
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