Duplex-Doppler ultrasonography in monitoring clinical pancreas transplantation.

The findings are reported that were obtained with duplex-Doppler ultrasonography (US) in seven diabetic patients who underwent pancreatic grafting with pancreaticocystostomy. Five normal functioning grafts showed homogenous echostructure and pulsed Doppler spectrum characteristics of low impedance vascular beds. Four of these patients developed graft rejection (five episodes). The remaining two grafts had pulsed Doppler evidence of venous thrombosis. It was not possible to differentiate graft rejection from venous thrombosis using real-time US. In both circumstances a heterogeneous pancreatic echostructure with a small amount of peripancreatic fluid and an increase in pancreas size were observed. Pulsed Doppler, however, showed absence of venous flow in both cases of venous thrombosis whereas all rejection episodes were characterized by an increase in arterial impedance. We conclude that duplex-Doppler US is a promising noninvasive method of detecting surgical complications and graft rejection in pancreatic transplant recipients.