Radiation Exposure from Diagnostic Imaging in a Cohort of Pediatric Transplant Recipients

Abstract

Recipients of solid organ transplants (SOT) have extensive diagnostic imaging (DI). The purpose of this study was to quantify this exposure. Children from northern Alberta with SOTs at Stollery Children’s Hospital, Edmonton, Alberta January 1, 2006, to July 31, 2012, were included. Effective doses of radiation were estimated using published norms for DI performed post-transplant up to October 16, 2014. The 54 eligible children had 6215 DI studies (5628 plain films, 293 computerized tomography (CT) scans, 149 positron emission topography (PET) -CT scans, 47 nuclear medicine scans and 98 cardiac catheterizations). Children less than 5 years of age underwent more DI studies than did older children (median (IQR) 140 (66–210) vs 49 (19–105), p = 0.010). Children with post-transplant lymphoproliferative disorder (N = 8) had more CT scans (median (IQR) 13 (5.5–36) vs 1 (0–5), p<0.001) and PET-CT scans (median (IQR) 3.5 (1.5–8) vs 0 (0–0), p<0.001) than did other children. The estimated cumulative effective dose attributed to DI studies post-transplant was median (range) 78 (4.1–400) millisievert (mSv), and 19 of 54 children (35%; 95% confidence interval 24–49%) had a dose >100 mSv. In conclusion, a significant proportion of pediatric transplant recipients have sufficient radiation exposure post-transplant for DI to be at potential risk for radiation-induced malignancies.

Persistence of Sarcopenia After Pediatric Liver Transplantation Is Associated With Poorer Growth and Recurrent Hospital Admissions

“…Computed tomography (CT) or magnetic resonance spectroscopy technology are often considered the gold standard for assessment of sarcopenia, but data are limited for assessment of body composition at our center in that these tests are more expensive and are not routinely performed at each annual clinic appointment. CT in particular is limited due to the potential radiation exposure associated with it , . No information regarding pubertal stage and its potential impact on sarcopenia prevalence was available.…”

“…CT in particular is limited due to the potential radiation exposure associated with it. 36,37 No information regarding pubertal stage and its potential impact on sarcopenia prevalence was available. While we observed an effect of age (median age <9.8 years) and gender (female) on higher sarcopenia prevalence, we were limited in our ability to examine the longitudinal evolution of sarcopenia with increasing age in the individual patient because the number of available DXA per patient was inconsistent.…”

Burden and consequences of retained cardiovascular implantable electronic device lead fragments after heart transplantation

“…15,16 Patients having undergone transplantation are also at a higher risk for malignancies. 15,16 Patients having undergone transplantation are also at a higher risk for malignancies.…”

“…Heart transplant patients are exposed to 3.5 times more radiation than the general population, and the majority of this exposure comes from cardiac procedures. 15,16 Patients having undergone transplantation are also at a higher risk for malignancies. 17 The Our report has several limitations including the inherent intrinsic limitations of a retrospective and single-center study.…”

Post-transplant lymphoproliferative disease is associated with early sternotomy and left ventricular hypoplasia during infancy: a population-based retrospective review

“…1,8,10 Radiation exposure In the present study, there was no evidence supporting increased radiation exposure in the cohort that developed post-transplant lymphoproliferative disorder, as reported in a study from Canada. 28 It is generally accepted that there is a dose-response relation between radiation and lymphoma; however, large studies show a protracted induction and a latency period for decades. 29 In the cohort of children undergoing heart transplantation in Gothenburg during a period of 25 years, all 10 of the 71 subjects developing posttransplant lymphoproliferative disorder had CHD, the majority had a hypoplastic left ventricle, all had undergone sternotomy, and the majority had undergone repeated surgery before transplantation.…”