1. To briefly review normal radiologic appearance of postoperative imaging anatomy. 2. To illustrate image findings of the main early complications of pancreatic transplant. 3. To discuss the optimal imaging technique for the diagnosis of each of these complications.

Our institution is one of the first referral transplant centers in Spain. Pancreatic transplantation is to this date the only effective treatment for type 1 diabetes mellitus, and is in most cases performed simultaneously with kidney transplant. It is a complex surgical intervention with different modifications (exocrine drainage, vascular anastomoses, etc…) subject to numerous complications. We retrospectively reviewed 55 cases attended in our institution in the last 5 years.

NORMAL POSTTRANSPLANTATION ANATOMY: (1, 3) There are several possibilities as to exocrine and endocrine pancreatic drainage, according to the surgical procedure. Exocrine drainage, that is, drainage of the pancreatic duct, may be arranged as: • ENTERIC DRAINAGE • BLADDER DRAINAGE Endocrine drainage, which refers to venous drainage which carries pancreatic hormones, may be disposed as: • SYSTEMIC DRAINAGE (more common) • PORTAL DRAINAGE Postoperative anatomy greatly depends on the drainage options. The recipient’s pancreas will be left untouched. The graft is composed of: the donor’s...

Radiologists must be familiarized with transplantation procedure and postsurgical imaging anatomy. Prompt diagnosis of graft-related complications isessential for graft survival. Multidetector CT is the technique which allows most complete evaluation of the pancreatic graft and its vascular and enteric/bladder anastomoses. MRI may be used as acomplementary tool, and may be helpful in the evaluation of graft parenchyma. US is a widely accessible, non-invasive tool very useful for detection and follow-up of fluid collections such ashematomas, seromas, pseudocysts and abscesses. Doppler and spectral Doppler analysis are...

Address correspondence to: Andrea Alcalá-Galiano, MD Department of Radiology Hospital Universitario 12 de Octubre, Madrid, Spain ADDRESS: Av. Córdoba s/n , 28041, Madrid, Spain email: [email protected]

Spectrum of imaging findings after pancreas transplantation with enteric exocrine drainage: part 1, posttransplantation anatomy. Freund MC, Steurer W, Gassner EM, Unsim KM, Rieger M, Koeigsrainer A et al. AJR 2004, 182:911-917. Spectrum of imaging findings after pancreas transplantation with enteric exocrine drainage: part 2, posttransplantation complications. Freund MC, Steurer W, Gassner EM, Unsim KM, Rieger M, Koeigsrainer A et al. AJR 2004, 182:919-925. Contrast-enhanced MR angiography after pancreas transplantation: normal appearance and vascular complications. Hagspiel KD, Nandalur K, Burkholder B, Angle JF, Brayman KL,...