Pancreatic transplants: CT with clinical and pathologic correlation.

Area of Science:

• Transplantation
• Radiology
• Gastroenterology

Background:

• Pancreatic allografts are crucial for managing certain endocrine and exocrine disorders.
• Assessing allograft complications requires accurate diagnostic imaging.
• Computed tomography (CT) is a common imaging modality used in post-transplant care.

Purpose of the Study:

• To evaluate the role of CT in diagnosing complications of pancreatic allografts.
• To correlate CT findings with clinical and pathological outcomes.
• To determine the utility of CT in managing patients with pancreatic allografts.

Main Methods:

• Retrospective review of 68 CT scans from 17 patients with pancreatic allografts.
• Clinical and pathological data were correlated with CT findings.
• Analysis focused on identifying abnormalities and their diagnostic significance.

Main Results:

• CT showed pancreatic inhomogeneity and peripancreatic inflammation in patients with complications, mimicking native pancreatitis.
• These CT findings were not specific for acute rejection, also appearing with infection, hemorrhage, and anastomotic leaks.
• CT did not detect changes in two of three patients with late rejection.
• CT was most beneficial in identifying intra-abdominal fluid collections (abscesses, hematomas, pseudocysts).

Conclusions:

• CT is not a reliable tool for diagnosing pancreatic allograft rejection.
• CT is valuable for detecting and characterizing fluid collections post-pancreatic transplantation.
• Percutaneous aspiration is useful for differentiating infected from sterile fluid collections, but drainage has limited therapeutic value.