The role of radiological imaging in organ transplantation

Abstract:

Radiological management is a part of routine workup in organ donors, as well as in organ recipients before, during and after transplantation. Ultrasonography with doppler analysis is used for follow-up of transplanted kidney and liver morphology and hemodynamics, especially in early posttransplant period. It is also the first radiological method used for preoperative evaluation of potential organ donors and recipients. If posttransplant complications are suspicious or ultrasonography didn’t reveal the diagnosis, further evaluation is required using computed tomography (CT ), or less frequently magnetic resonance imaging (MRI). Hepatic and renal CT angiography in organ donors can depict anatomic variations of vascular supply which enables surgical selection of the donor. In the liver recipient liver morphology, presence of focal lesions and variations of liver vascularization should be depicted. Doppler analysis and detection of iliac artery calcifications on plain radiography is usually sufficient for decision which iliac artery should be used for transplanted kidney arterial anastomosis. Coronary CT angiography can be used for detection of graft vasculopathy after heart transplatation because it can depict both luminal stenosis and wall thickenning, but images are often tehnically degraded by elevated heart rate of the denervated transplanted heart. 

Key words:
computed tomography; heart transplantation; kidney transplantation; liver transplantation; magnetic resonance; pancreas transplantation; ultrasonography