Departments of Radiology and Diagnostic Imaging, University of Alberta Hospital, Edmonton, AB, Canada.
Radiographics. 2013 May;33(3):633-52. doi: 10.1148/rg.333125728.
Transplantation is the surgical treatment of choice for end-stage organ failure. Transplantation procedures performed in the abdomen include liver, renal, pancreas, islet, intestinal, and multivisceral transplantations. Imaging plays a pivotal role in the posttransplantation setting for monitoring the transplant allograft and screening for complications. Knowledge of the surgical techniques employed in abdominal transplantation is essential because it facilitates radiologic understanding and interpretation of the posttransplantation anatomy. This article includes a basic description of the standard surgical techniques performed in the abdomen, with emphasis on the relevant vascular anastomotic reconstructions used. Posttransplantation complications can be broadly classified as vascular or nonvascular in origin. Many of these complications can be accurately depicted and characterized at imaging and dealt with definitively by using interventional radiology techniques, which can be graft- and life-saving and can obviate further complex surgical intervention. The article discusses imaging appearances of vascular complications and their consequences after transplantation in the abdomen. These vascular complications include arterial thrombosis, arterial stenosis, venous thrombosis and stenosis, arteriovenous fistula formation, and pseudoaneurysm formation. The relevant predisposing factors, clinical features, imaging appearances, and potential treatment options for vascular complications of various types of transplantation are presented in a logical and integrated fashion. Knowledge and imaging recognition of the posttransplantation vascular complications discussed in this article will aid radiologists in accurate imaging characterization and thereby facilitate appropriate clinical management and therapy.
移植是治疗终末期器官衰竭的首选外科治疗方法。在腹部进行的移植手术包括肝、肾、胰腺、胰岛、肠和多器官移植。成像在移植后环境中起着至关重要的作用，用于监测移植移植物并筛查并发症。了解腹部移植中使用的手术技术至关重要，因为它有助于放射学理解和解释移植后的解剖结构。本文包括对腹部实施的标准手术技术的基本描述，重点介绍使用的相关血管吻合重建技术。移植后并发症可大致分为血管性或非血管性。许多这些并发症可以在成像时准确地描绘和特征化，并通过使用介入放射学技术进行明确处理，这些技术可以挽救移植物和生命，并避免进一步的复杂手术干预。本文讨论了腹部移植后血管并发症及其后果的影像学表现。这些血管并发症包括动脉血栓形成、动脉狭窄、静脉血栓形成和狭窄、动静脉瘘形成和假性动脉瘤形成。本文以逻辑和综合的方式介绍了各种类型移植的血管并发症的相关易患因素、临床特征、影像学表现和潜在的治疗选择。本文讨论的移植后血管并发症的知识和影像学识别将有助于放射科医生进行准确的影像学特征描述，从而促进适当的临床管理和治疗。
