RADIOLOGIC EVALUATION OF SIMULTANEOUS PANCREAS-KIDNEY TRANSPLANTATION

We describe the radiographic imaging modalities that were used in the first twelve consecutive patients who have undergone simultaneous panc reas and kidney transplantation (SPK) at our institution, The total nu mber of examinations undertaken in this study included ultrasound (n=2 2), radionucleide scanning (n=19), cystography (n=14), computed tomogr aphy (n=2) and magnetic resonance imaging (n=1), Eighteen percent (5/2 2) ultrasound examinations were abnormal (perirenal collection [n=4], peri-pancreatic collection [n=1]). Two collections required aspiration and were confirmed as lymphocoeles. Cystography showed ureteric reflu x in two patients and radionucleide DTPA scanning revealed a delay in the excretory phase in 20% of patients, CT was used in two patients wi th SPK and demonstrated large peri-pancreatic collections, No episodes of rejection or late graft pancreatitis were noted in this series. We discuss the role of radiographic imaging in detecting early graft fai lure and also in defining the surgical complications that may arise fo llowing transplantation. We also outline the merits and disadvantages of each imaging modality, We conclude that the most useful initial ima ging techniques in the evaluation of patients following SPK are ultras ound including Doppler and nuclear medicine.