Intestinal and multivisceral transplantation

Abstract

Intestinal transplantation is carried out in only a handful of centers in the world. However, patients with such transplantation may be seen at almost any institution and radiologists should be familiar with the expected normal anatomy and complications of intestinal transplantation and its variants. In this paper, we discuss the anatomy and complications following intestinal and multivisceral transplantations. We review the literature and present the findings in a cohort of 46 patients who underwent these procedures at our institution. It is important not to misinterpret the normal adaptation of the transplanted intestine for disease. Some of the complications, including infections, vascular complications, and recurrent tumor, are conclusively diagnosed on imaging studies. Imaging studies may raise the diagnosis of complications such as rejection, graft-versus-host disease, posttransplant lymphoproliferative disease, and sclerosing peritonitis.

Extravascular complications following abdominal organ transplantation

“…Rarely, transplants may be complicated by graft-versus-host disease with the highest incidence for intestinal transplants (5e6%) due to the large quantity of immune-related tissue in the intestines. 39 Graft-versushost disease in the intestines has non-specific imaging findings, such as bowel-wall thickening, mucosal hyperenhancement, mesenteric adenopathy, and mesenteric hypervascularity. 39 Neoplasms Solid-organ transplant recipients have a two-to fourfold increased risk of developing de novo malignancies when compared to the general population.…”

“…39 Graft-versushost disease in the intestines has non-specific imaging findings, such as bowel-wall thickening, mucosal hyperenhancement, mesenteric adenopathy, and mesenteric hypervascularity. 39 Neoplasms Solid-organ transplant recipients have a two-to fourfold increased risk of developing de novo malignancies when compared to the general population. 41 Immunosuppression and oncogenic viruses are implicated as the major causative factors.…”

Detection of Postoperative Intestinal Ischemia in Small Bowel Transplants

“…Monitoring for the detection of POII can be performed by endoscopy [15, 16]. This method is reliable for the evaluation of the transplant and, as biopsies can be harvested, outstanding for the detection of rejection as well.…”

The optimal intestinal segment length for experimental size‐mismatched intestinal transplantation: Defining the maximum length with the lowest blood flow needs in a porcine model

“…However, the waiting time on transplant list for a SBTX is long, leading to a high mortality in listed patients. One of the main reasons for long waiting times is the limited availability of donor organs . Most of the patients on the waiting list for a SBTX are children under 5 years of age.…”

“…One of the main reasons for long waiting times is the limited availability of donor organs. 11 Most of the patients on the waiting list for a SBTX are children under 5 years of age. Finding suitable size-matched organs for these patients is even more problematic.…”