Abstract
We present a pictorial essay on pediatric intestinal transplantation that describes the indications for pediatric intestinal transplantation, surgical technique, and the role of imaging in the pre-transplant work-up and detection of post-transplant complications. We illustrate the normal post-transplant imaging appearance and common complications, including rejection, infection, post-transplant lymphoproliferative disease (PTLD), mechanical dysfunction and vascular complications. We conclude with an imaging algorithm for suspected post-transplant complications based on clinical scenarios.
Similar content being viewed by others
References
Fishbein TM (2009) Intestinal transplantation. N Engl J Med 361:998–1008
2009 Annual Report of the U.S. Organ Procurement and Transplantation Network and the Scientific Registry of Transplant Recipients: Transplant Data 1997–2009. Department of Health and Human Services, Health Resources and Services Administration, Healthcare Systems Bureau, Division of Transplantation
Javid PJ, Malone FR, Reyes J et al (2010) The experience of a regional pediatric intestinal failure program: successful outcomes from intestinal rehabilitation. Am J Surg 199:676–679
Unsinn KM, Koenigsrainer A, Rieger M et al (2004) Spectrum of imaging findings after intestinal, liver-intestinal, or multivisceral transplantation: part 1, posttransplantation anatomy. AJR 183:1275–1283
Ruiz P, Kato T, Tzakis A (2007) Current status of transplantation of the small intestine. Transplantation 83:1–6
Lappas JC (2003) Imaging of the postsurgical small bowel. Radiol Clin North Am 41:305–326
Delis KT, Gloviczki P (2005) Middle aortic syndrome: from presentation to contemporary open surgical and endovascular treatment. Perspect Vasc Surg Endovasc Ther 17:187–203
Sethna CB, Kaplan BS, Cahill AM et al (2008) Idiopathic mid-aortic syndrome in children. Pediatr Nephrol 23:1135–1142
Sebastia C, Quiroga S, Boye R et al (2003) Aortic stenosis: spectrum of diseases depicted at multisection CT. Radiographics 23 Spec No:S79-91
Quek SC, Tan L, Quek ST et al (2000) Abdominal coarctation and Alagille syndrome. Pediatrics 106:E9
Terramani TT, Salim A, Hood DB et al (2002) Hypoplasia of the descending thoracic and abdominal aorta: a report of two cases and review of the literature. J Vasc Surg 36:844–848
Phillips GS, Vo NJ, Ishak GE et al (2010) Splenic artery aneurysm: a diagnostic challenge in the setting of extensive portal venous collaterals. Pediatr Radiol 40:1278–1280
Corness JA, McHugh K, Roebuck DJ et al (2006) The portal vein in children: radiological review of congenital anomalies and acquired abnormalities. Pediatr Radiol 36:87–96, quiz 170–171
Gallego C, Miralles M, Marin C et al (2004) Congenital hepatic shunts. Radiographics 24:755–772
Paolantonio P, Ferrari R, Vecchietti F et al (2009) Current status of MR imaging in the evaluation of IBD in a pediatric population of patients. Eur J Radiol 69:418–424
Toma P, Granata C, Magnano G et al (2007) CT and MRI of paediatric Crohn disease. Pediatr Radiol 37:1083–1092
Babyn PS (2010) Imaging of the transplant liver. Pediatr Radiol 40:442–446
Vasanawala SS (2010) MRI of the liver–how to do it. Pediatr Radiol 40:431–437
Coley BD (2004) Pediatric applications of abdominal vascular Doppler: Part II. Pediatr Radiol 34:772–786
Unsinn KM, Koenigsrainer A, Rieger M et al (2004) Spectrum of imaging findings after intestinal, liver-intestinal, or multivisceral transplantation: part 2, posttransplantation complications. AJR 183:1285–1291
Bach DB, Levin MF, Vellet AD et al (1992) CT findings in patients with small-bowel transplants. AJR 159:311–315
Campbell WL, Abu-Elmagd K, Federle MP et al (1993) Contrast examination of the small bowel in patients with small-bowel transplants: findings in 16 patients. AJR 161:969–974
Greenstein SM, Friedmann JC, Prowse O (2009) Intestinal transplantation. Emedicine. Available via http://emedicine.medscape.com/article/1013245-overview. Accessed 15 March 2011
Macedo C, Sindhi R, Mazariegos GV et al (2005) Sclerosing peritonitis after intestinal transplantation in children. Pediatr Transplant 9:187–191
Lopez-Benitez R, Schlieter M, Hallscheidt PJ et al (2008) Successful arterial thrombolysis and percutaneous transluminal angioplasty for early hepatic artery thrombosis after split liver transplantation in a four-month-old baby. Pediatr Transplant 12:606–610
Singhal A, Stokes K, Sebastian A et al (2010) Endovascular treatment of hepatic artery thrombosis following liver transplantation. Transpl Int 23:245–256
Maruzzelli L, Miraglia R, Caruso S et al (2010) Percutaneous endovascular treatment of hepatic artery stenosis in adult and pediatric patients after liver transplantation. Cardiovasc Interv Radiol 33:1111–1119
Carnevale FC, Borges MV, Moreira AM et al (2006) Endovascular treatment of acute portal vein thrombosis after liver transplantation in a child. Cardiovasc Interv Radiol 29:457–461
Liu XL, Li FQ, Li X et al (2009) Treatment of hepatic venous outflow stenosis after living donor liver transplantation by insertion of an expandable metallic stent. Hepatobiliary Pancreat Dis Int 8:424–427
Alonso L, Alvite M, Seoane M et al (2009) Interventional radiologist treatment for inferior vena caval thrombosis in a liver transplant recipient. Transplant Proc 41:1060–1061
Heidenhain C, Werk M, Gebauer B et al (2010) Endovascular treatment of supra-celiac aortic pseudoaneurysms following liver transplantation. Clin Transplant 24:188–191
Sauvat F, Dupic L, Caldari D et al (2006) Factors influencing outcome after intestinal transplantation in children. Transplant Proc 38:1689–1691
Author information
Authors and Affiliations
Corresponding author
Additional information
CME activity
This article has been selected as the CME activity for the current month. Please visit the SPR web site at www.pedrad.org on the Education page and follow the instructions to complete this CME activity.
Rights and permissions
About this article
Cite this article
Phillips, G.S., Bhargava, P., Stanescu, L. et al. Pediatric intestinal transplantation: normal radiographic appearance and complications. Pediatr Radiol 41, 1028–1039 (2011). https://doi.org/10.1007/s00247-011-2094-3
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00247-011-2094-3