BMI Poster BTS 2010
Contrast Enhanced Ultrasonography in Simultaneous Pancreas and Kidney Transplantation: Development of a Novel Imaging Technique H. Khambalia, S. Lee, L. Kenderdine, D. van Dellen, T. Augustine Departments of Renal and Pancreas Transplantation and Radiology, Manchester Royal Infirmary, Manchester, and Department of Radiology
Introduction
Methods
Vascular complications following SPKT remain the most common contributor to graft loss Current investigative options are expensive, often cumbersome, involve ionising radiation and potentially nephrotoxic contrast agents Contrast Enhanced Ultrasound (CEUS) utilizes micro-bubble contrast agent to identify flow and morphology of organ systems Newer technologies allow calculation of organ perfusion quantification This potentially allows for assessment of the allograft vasculature, early diagnosis of vascular complications and assessment of whole organ perfusion, without the need for nephrotoxic contrast agent
We present the early results of a trial assessing the feasibility and benefits of CEUS in SPKT
Results Recipient Demographics (n= 12)
Donor Demographics
10 (83.3%)
Male
Mean Age
39.33 (SD 8.92) Mean Age
32.83 (SD 10.53)
Mean BMI
25.99 (3.14)
8 (66.7%)
Dialysis status
Pre, 5 (41.7%) Pancreas HD, 6 (50%) position PD, 1 (8.3%)
DBD
All CEUS were performed on the ICU by a dedicated transplant radiology team following SPKT
•
All scans were conducted on a GE Logiq S8 US Scanner and included initial analysis with standard B-mode ultrasonography, followed by duplex and CEUS
•
During the CEUS phase of the scan, 1mg of SonoVue, diluted to 10ml with normal saline, was infused at 2ml/min via a central venous catheter
•
Analysis and quantification of the CEUS were carried out using VueBox software, version 4.3.0
Normal CEUS image of kidney and pancreas allograft (arterial Y-graft
Correlation of amylase at time of CEUS and time taken to visualise organ
highlighted). CEUS aided identification of allograft organs when
perfusion (s); p= 0.019, r= 0.799
compared to B-mode USS and duplex
Male
•
8 (66.7%)
Head-up, 11 (91.7%)
Conclusions • CEUS offers an innovative indicator of graft perfusion and morphology in the peri-operative period following SPKT • It appears to have utility in identifying acute inflammatory processes within the allograft pancreas
Introduction
Methods
Vascular complications following SPKT remain the most common contributor to graft loss Current investigative options are expensive, often cumbersome, involve ionising radiation and potentially nephrotoxic contrast agents Contrast Enhanced Ultrasound (CEUS) utilizes micro-bubble contrast agent to identify flow and morphology of organ systems Newer technologies allow calculation of organ perfusion quantification This potentially allows for assessment of the allograft vasculature, early diagnosis of vascular complications and assessment of whole organ perfusion, without the need for nephrotoxic contrast agent
We present the early results of a trial assessing the feasibility and benefits of CEUS in SPKT
Results Recipient Demographics (n= 12)
Donor Demographics
10 (83.3%)
Male
Mean Age
39.33 (SD 8.92) Mean Age
32.83 (SD 10.53)
Mean BMI
25.99 (3.14)
8 (66.7%)
Dialysis status
Pre, 5 (41.7%) Pancreas HD, 6 (50%) position PD, 1 (8.3%)
DBD
All CEUS were performed on the ICU by a dedicated transplant radiology team following SPKT
•
All scans were conducted on a GE Logiq S8 US Scanner and included initial analysis with standard B-mode ultrasonography, followed by duplex and CEUS
•
During the CEUS phase of the scan, 1mg of SonoVue, diluted to 10ml with normal saline, was infused at 2ml/min via a central venous catheter
•
Analysis and quantification of the CEUS were carried out using VueBox software, version 4.3.0
Normal CEUS image of kidney and pancreas allograft (arterial Y-graft
Correlation of amylase at time of CEUS and time taken to visualise organ
highlighted). CEUS aided identification of allograft organs when
perfusion (s); p= 0.019, r= 0.799
compared to B-mode USS and duplex
Male
•
8 (66.7%)
Head-up, 11 (91.7%)
Conclusions • CEUS offers an innovative indicator of graft perfusion and morphology in the peri-operative period following SPKT • It appears to have utility in identifying acute inflammatory processes within the allograft pancreas
