Contrast-enhanced ultrasound of the transplant pancreas in the post-operative setting.

Abstract:

BACKGROUND/OBJECTIVES:Vascular thrombosis is the most common cause of early graft loss after transplantation. Routine grayscale and Doppler ultrasound frequently fail to adequately visualize vascular compromise. Contrast-enhanced ultrasound is a novel approach to identifying these complications. METHODS:This was a prospective study of 22 consecutive patients who received pancreas transplant at our institution between 2017 and 2018. All allografts were implanted with systemic venous and enteric exocrine drainage. Perfusion was assessed in the immediate post-operative period using grayscale, Doppler, and contrast-enhanced ultrasound. Imaging findings were compared between those who required surgical re-intervention and those who did not in order to evaluate for differences in perfusion. RESULTS:Of the 22 transplants, 15 did not require surgical re-intervention and were considered normal. These allografts demonstrated prompt and uniform enhancement, with washout usually by 90 seconds. All patients who had abnormal CEUS underwent re-exploration. Perfusion was acceptable or restored in all cases. Two patients ultimately required allograft pancreatectomy. Two patients had normal glands, and the remaining 3 grafts were salvaged following intervention. CONCLUSIONS:Contrast-enhanced ultrasound provides rapid evaluation of allograft perfusion following pancreas transplantation. The differences in perfusion provide a novel way of evaluating for complications in the immediate post-transplant period.

journal_name

Clin Transplant

journal_title

Clinical transplantation

authors

Swensson J,Nagaraju S,O'Brien D,Tann M,Shah A,Mangus R,Powelson J,Fridell J

doi

10.1111/ctr.13733

subject

Has Abstract

pub_date

2019-12-01 00:00:00

pages

e13733

issue

12

eissn

0902-0063

issn

1399-0012

journal_volume

33

pub_type

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