Ionizing Radiation Exposure From Imaging in Pediatric Solid Organ Transplant Recipients

Area of Science:

• Pediatric imaging
• Transplant medicine
• Radiation oncology

Background:

• Pediatric solid organ transplant recipients require extensive medical imaging.
• Data on cumulative radiation dose from these imaging procedures are limited.
• This study aimed to quantify cumulative ionizing radiation exposure and identify its sources in this population.

Purpose of the Study:

• To quantify the cumulative effective dose (CED) of ionizing radiation in pediatric solid organ transplant recipients.
• To identify the primary contributors to radiation exposure, including imaging modality and indication.
• To stratify radiation exposure based on transplant type and follow-up duration.

Main Methods:

• Retrospective cohort study of 543 children (0-18 years) undergoing their first solid organ transplant.
• Follow-up from first imaging pre-transplant until transfer of care, death, or 28 months post-enrollment.
• Cumulative effective dose (CED) estimated and stratified by era, modality, indication, and organ group.

Main Results:

• Median CED was 21 mSv across 29,821 imaging studies in 543 children over a median 3.4-year follow-up.
• Computed tomography accounted for 44% of CED; most studies were for clinical care, not planned protocols.
• Radiation exposure was highest in multi-organ recipients and lowest in kidney recipients.

Conclusions:

• Most pediatric solid organ transplant recipients experienced low-to-moderate radiation exposure from medical imaging.
• Optimizing ionizing imaging modalities to reduce radiation dose is crucial.
• Promoting the use of non-ionizing imaging modalities is recommended to minimize cumulative exposure.