Evaluation of pancreatic allografts with sonography

Gimenez, Juan M., Bluth, Edward I., Simon, Allison and Troxclair, Laurie (2012) Evaluation of pancreatic allografts with sonography. Journal of Ultrasound in Medicine, 31 7: 1041-1051.

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Author Gimenez, Juan M.
Bluth, Edward I.
Simon, Allison
Troxclair, Laurie
Title Evaluation of pancreatic allografts with sonography
Journal name Journal of Ultrasound in Medicine  (ERA 2012 Listed)    (ERA 2010 Rank C)   Check publisher's open access policy
Publication date 2012-07
Sub-type Article
Volume number 31
Issue number 7
ISSN 0278-4297
1550-9613
Start page 1041
End page 1051
Total pages 11
Place of publication Laurel, MD, U.S.A.
Publisher American Institute for Ultrasound in Medicine
Collection year 2013
Language eng
Formatted abstract Objectives— The purposes of this study were to develop a protocol for evaluating pancreas allografts, to describe a method for successfully studying pancreatic transplants, and to determine whether the resistive index (RI) of the splenic artery is a useful differentiator between complications.

Methods— We retrospectively analyzed clinical, surgical, procedural, and radiologic reports in 51 consecutive patients undergoing 182 sonographic examinations during a 4.5-year period. Complications included splenic vein thrombosis, rejection, and pancreatitis. We obtained RIs in normal and complication groups and performed mixed model regression methods and receiver operating characteristic analysis.

Results— The mean RI ± SD for normal transplants was 0.65 ± 0.09; for splenic vein thrombosis, 0.76 ± 0.09; after resolution of splenic vein thrombosis, 0.73 ± 0.09; during rejection, 0.94 ± 0.09; after successful treatment of rejection, 0.74 ± 0.09; for pancreatitis, 0.83 ± 0.09; and for fluid collections, 0.66 ± 0.09. There was a statistically significant difference (P < .05) between normal transplants and splenic vein thrombosis (P = .0003), rejection (P < .0001), and pancreatitis (P = .04). A significant difference was also seen between rejection and successful treatment thereof (P < .0001).

Conclusions— We developed a protocol that allowed us to successfully evaluate 96% of the pancreatic allografts studied. Furthermore, our data show that the RI can be used as a therapeutic guide. When the RI is less than 0.65, the risk of vascular abnormalities is very low; however, fluid collections may be present. When greater than 0.75, splenic vein thrombosis, pancreatitis, or rejection should be suspected. When greater than 0.9, rejection must be seriously considered.
Keyword Pancreatic allograft
Resistive index
Risk evaluation
Sonography
Transplantation
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article
Collections: Official 2013 Collection
School of Medicine Publications
 
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Created: Mon, 03 Sep 2012, 00:15:19 EST by Matthew Lamb on behalf of School of Medicine