Type:
Educational Exhibit
Keywords:
Performed at one institution, Not applicable, Prospective, Transplantation, Lymphoma, Infection, Surgery, MR-Enterography, MR-Angiography, MR, Paediatric, Gastrointestinal tract, Anatomy
Authors:
J. Loo, J. Chen, P. Iskander, T. Hall, S. Ghahremani; Los Angeles/US
DOI:
10.26044/ecr2020/C-07594
Background
Intestinal failure is a rare but devastating condition in pediatric patients that is often caused by short bowel syndrome (SBS) secondary to necrotizing enterocolitis, volvulus, atresia, or other etiology. With recent advances in intestinal rehabilitation (IR) related to dietary and surgical lengthening innovations, the need for transplantation has decreased.
Nevertheless, some patients who develop cholestasis and end stage liver disease (ESLD) from parenternal nutrition (PN) will require transplantation. Even as intestinal rehabilitation methods have improved and reduced the need for transplants, multivisceral (MVTx) transplantation has also made strides due to improvements in immunosuppression, surgical technique, and post-transplant care.
Given the high acuity of patients that do ultimately undergo these procedures, radiologist recognition of post-operative complications is critical for graft survival and improved outcomes.
This presentation will review the indications and relevant anatomy for these types of transplantations. Magnetic resonance (MR) findings related to post-transplantation complications will be presented with imaging correlates from other modalities (CT, PET/CT, US) as needed.
The cases here were compiled from a review of over 120 patients at UCLA over the last 23 years (1996-2019) who had either an isolated intestinal, liver-intestinal, or multivisceral transplantation.