Ultrasound in solid organ transplant assessment
Laura Marsland, King's College Hospital
Aim
To present the role of ultrasound (US) in the assessment of solid organ transplants, for both routine, postoperative
surveillance, as well as for the investigation of possible complications.
Method
Pictorial review of post-operative US assessment of both liver and kidney transplants, as well as of common
and/or important complications.
Results
The number of solid organ transplants performed in the United Kingdom has almost doubled in the last
decade. The most commonly transplanted organs are the kidney and liver.
Transplant grafts are actively monitored following transplant for the entirety of the graft life, as complications,
particularly vascular complications, can lead to graft failure. Whilst acute complications are more likely to occur
in the days immediately following the procedure, whilst the patient remains in a specialist transplant unit,
subacute and chronic complications may well trigger attendance or admission to non-specialist centres.
US imaging, including B-mode and Doppler assessment, is generally first line in assessment of solid
organ transplants when there is a need to exclude post-transplant complications and all radiologists and
sonographers should be competent and able to do so.
This pictorial review will describe the fundamental requirements for assessment of the post-transplant kidney
and liver graft, as well as demonstrate how ultrasound can be used to identify complications in the acute,
subacute and chronic setting.
Conclusion
Suspected complications following solid organ transplant may present in a non-specialist setting and US
assessment is the first line imaging modality. It is important that all radiologists and sonographers are
competent in US assessment in this important clinical context.