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Contrast‐enhanced ultrasound of the transplant pancreas in the post‐operative setting
Author(s) -
Swensson Jordan,
Nagaraju Santosh,
O'Brien Daniel,
Tann Mark,
Shah Angela,
Mangus Richard,
Powelson John,
Fridell Jonathan
Publication year - 2019
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/ctr.13733
Subject(s) - medicine , contrast (vision) , contrast enhanced ultrasound , ultrasound , pancreas , radiology , pancreas transplantation , transplantation , surgery , kidney transplantation , artificial intelligence , computer science
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.