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E2061. Evaluation of Pancreatic Transplants and Complications
Authors
  1. David Bass; University of Rochester
  2. Abhinav Patel; University of Rochester
  3. Akshya Gupta; University of Rochester
  4. Stan Weiss; University of Rochester
Background
Simultaneous pancreas and kidney transplants are growing in popularity. Overall, many radiologists have little experience evaluating these post-operative patients, and it can be difficult to assess for complications. In addition, evaluation of the technical approach of the operation requires knowledge of possible anatomical variants to correctly diagnose the patient.

Educational Goals / Teaching Points
Review pancreatic transplants including the variable postoperative anatomy in order to facilitate understanding of both common and infrequent complications that may occur. Common complications such as graft venous occlusion, transplant pancreatitis, and rejection will be discussed. In addition to the discussion of infrequent pathologies such as graft arterial thrombus, primary malignancy of the graft, and urinary tract abscesses.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
An effort was undertaken to study post-operative pancreatic transplant patients and to identify complications. Imaging was observed over several modalities, with the majority of the cases identified being ultrasound or Computed Topography. Many patients with several years of follow-up were identified. Several were observed in which no morbidity or mortality had taken place. Complications that were identified included graft pancreatitis, pancreatic graft rejection, pancreatic arterial occlusion, pancreatic venous stenosis, graft pseudocyst, urinary tract abscesses, and adenocarcinoma of the pancreatic graft.

Conclusion
As pancreatic transplants continue to grow in popularity, it is important to understand possible complications and how to evaluate them. Many of these complications can be easily overlooked given the overall low volume of simultaneous pancreas and kidney transplants as compared to kidney transplants. Experience identifying potential complications and anatomic variations within pancreatic transplants is essential for the diagnosis of postoperative pathology.