Transplantation in the United States alone have been increasing yearly, with 39,719 transplants being performed in 2019. Renal transplant by itself accounted for the vast majority of them, with 23,401 renal transplants performed in 2019; this is an increase of 10.7% from the previous year. With the prevalence of transplants increasing, the imaging of transplants is increasingly important. Due to the complicated nature of transplantation, our purpose is to educate on the various issues that occur with transplantation (with an emphasis on renal transplants) to allow radiologist to better assess and diagnose these pathologies, especially those in centers where transplants are not routinely imaged.
Educational Goals / Teaching Points
This exhibit will discuss some of the more common, as well as some rarer, transplantation pathology as well as some pearls and pitfalls for accurate diagnosis of these pathologies. This will be done via multiple choice questions in a continuing medical education format highlighting the important imaging considerations for each case.
Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
We will discuss various post transplant pathologies. Given that many of these transplants are imaged using ultrasound, we will focus primarily, but not exclusively, on ultrasound techniques for given pathologies. These include vascular etiologies, such as vascular thromboses, AVF (arteriovenous fistula), and mimickers using color and doppler ultrasound imaging. We will also identify various postoperative issue such as hematomas, seromas, and lymphangiomas using various modalities. Additionally, we will describe hydronephrosis and its etiologies in transplants. Lastly, we will examine masses of transplanted kidneys including RCC (Renal Cell Carcinoma) and PTLD (Post-Transplant Lymphoproliferative Disorder, pseudotumor) using ultrasound, CT (Computed Tomography), and MRI (Magnetic resonance imaging).
We hope that educate radiologist on the various transplant complications and give important takeaways when evaluating renal transplants to make accurate and timely diagnoses.