Pancreatic transplant rejection: assessment with duplex US.
The value of duplex ultrasonography (US) in the assessment of pancreatic transplants was studied in 22 patients over a 1 1/2-year period. Ninety-eight duplex US examinations were performed, and the Doppler arterial resistive indexes (RIs) correlated with clinical events after transplantation. The RI was 0.70 or less in the parenchymal vessels in all instances of normal transplant function and greater than 0.70 in seven of eight clinical episodes of rejection (87.5%). In all studies performed during these eight cases of rejection, the positive predictive value of an RI exceeding 0.70 was 100%. The negative predictive value of an RI of less than 0.70 in excluding rejection was 90%. High RI values were not found in isolated episodes of cyclosporine toxicity, pancreatitis, peripancreatic hemorrhage, or infection. Duplex US may prove to be more accurate in the diagnosis of rejection of pancreatic transplants versus renal transplants because the former cases have fewer causes of increased vascular impedance and diminished perfusion.
Patel
B
B
John Cochran Veterans Administration Hospital, St Louis., MO.
Wolverson
M K
MK
Mahanta
B
B
D005260:Female; D006084:Graft Rejection; D006801:Humans; D008297:Male; D010179:Pancreas / Q000098:blood supply; D016035:Pancreas Transplantation; D013157:Splenic Artery / Q000503:physiopathology; D014463:Ultrasonography; D014655:Vascular Resistance