Multi detector computed tomography (MDCT) for the diagnosis of early complications after pancreas transplantation.
OBJECTIVE
Solitary Pancreas (SPT) and simultaneous kidney-pancreas (SPKT) transplants carry a high risk of surgical complications that may lead to the loss of the pancreas graft and impact later kidney function. The purpose of this study was to investigate the role of MDCT in the diagnosis of early complications and its impact on kidney function.


METHODS
All patients receiving SPT or SPKT over 5 years were retrospectively included. Complications that occurred within the first 15 days were registered and MDCT data analyzed. Data regarding donor, transplant, and recipient characteristics as well as transplantation procedures were analyzed according to the occurrence of early complications. Kidney function at day 3 following MDCT was evaluated.


RESULTS
One hundred and forty-one patients were included (85 men, 56 women; mean age 40.1 years, SD 7.7) with 119 SPKT and 22 SPT. Sixty-four complications were registered in 50 patients. Partial (P-) or complete venous thrombosis (C-VT) occurred in 12.1 % (n = 17), arterial thrombosis (AT) in 1.4 % (n = 2), and hemorrhage in 8.5 % (n = 12) of all patients. For venous thrombosis, the predominant risk factor was body mass index (BMI) for either recipients (P < 0.05) or donors (P < 0.01). Median time for venous thrombosis diagnosis with MDCT was 4 days. Kidney function was not altered following MDCT. Fourteen pancreatectomies were necessary. All patients with C-VT and AT had to undergo graftectomy.


CONCLUSIONS
Vascular complications occurred early following grafting. Systematic early-enhanced MDCT at day 2-3 should be adequate to detect early thrombosis, especially if risk factors have been identified, without induced kidney function alteration.
Central Department of Radiology and Medical Imaging, Hôtel-Dieu, CHU Nantes, 1 Place Alexis Ricordeau, 44093, Nantes Cedex 1, France.
M
M
Vincent
O
O
Morla
J
J
Branchereau
G
G
Karam
B
B
Dupas
E
E
Frampas
D000328:Adult; D003287:Contrast Media; D005260:Female; D006470:Hemorrhage / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography / Q000379:methods*; D010179:Pancreas / Q000000981:diagnostic imaging; D016035:Pancreas Transplantation; D011183:Postoperative Complications / Q000000981:diagnostic imaging*; D011856:Radiographic Image Enhancement / Q000379:methods; D012189:Retrospective Studies; D012307:Risk Factors; D013927:Thrombosis / Q000000981:diagnostic imaging; D020246:Venous Thrombosis / Q000000981:diagnostic imaging; D055815:Young Adult
D003287:Contrast Media