Following kidney allotransplantation a great number of complications threaten the patient and his graft, e.g. acute tubular necrosis, acute and chronic rejection, urologic and vascular complications and complications due to the immunosuppressive treatment. During the last decade a number of technical developments in radionuclide, ultrasonographic and radiographic imaging and intervention has significantly improved the possibility of early recognition and handling of such complications. Knowledge of the capability and limitations of the various techniques is of vital importance for their rational use. The aim of this review article is to give a short description of the various imaging modalities, the rational monitoring of the posttransplant patient, and possible handling of complications by the aid of imaging techniques.

Angiography↗

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Anatomic variants of the hepatic arteries.

The anatomic variants of the hepatic arteries observed in 216 abdominal arteriographies were analysed. A comparison was made with MICHELS' work based upon 200 anatomic dissections, and SUZUKI'S investigation of 200 abdominal arteriographies. Seven not previously classified anatomic variants of the hepatic arteries were found. The large number of variants may be ascribed to intricacies in the development of the vascular supply in the embryo and to the normal caudal displacement of the liver taking place in the embryo and fetus. Knowledge concerning existing variants is important in performing surgery, embolization and intra-arterial infusion chemotherapy in the hepatic region.

Hepatic Artery↗

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Intravenous injection of ioxilan, iohexol and diatrizoate. Effects on urine profiles in the rat.

Effects of intravenous ioxilan, a new third generation non-ionic contrast medium, diatrizoate, iohexol and saline on urine profiles were compared. Albumin, glucose, sodium, phosphate, and the enzymes NAG, LDH and GGT were followed in 24 normal rats over 7 days. Diatrizoate significantly affected all profile components during the first two hours. Albuminuria was significantly greater after diatrizoate than after iohexol or ioxilan, and excretion of glucose, LDH and GGT was significantly higher than after ioxilan. Both iohexol and ioxilan increased the excretion of albumin, LDH and GGT, while iohexol also significantly increased excretion of glucose and sodium. There was a greater excretion of glucose and GGT after iohexol than after ioxilan. Saline did not induce any changes. At day 7, serum sodium, urea, creatinine, and albumin were normal for all test substances, and kidney histology revealed no difference between the groups of animals. It is thus concluded that both high osmolar ionic and low osmolar non-ionic contrast media may cause temporary glomerular and tubular dysfunction in rats. In this model, the kidney is affected most by diatrizoate, less by iohexol, and least by ioxilan.

Animals↗

PubMedDate not supplied

Effects of intravenous injection of diatrizoate, iohexol or ioxilan on renal size, urine profiles and blood profiles in the rabbit.

Diatrizoate, iohexol or ioxilan were injected intravenously in 18 rabbits. The contrast medium passage through the kidneys was recorded on digital subtraction images for the first 50 s followed by 100 mm exposures up to 15 min after injection. The renal area was measured planimetrically. Urine profiles (glucose, phosphate, LDH, GGT, NAG), blood profiles (potassium, urea) and the relative clearance of albumin and sodium were followed for 5 days and compared with a control group injected with saline. All kidneys were examined by light and immunofluorescence microscopy. All three contrast media produced excellent arteriograms and urograms. The three different contrast media caused a rapid increase of the kidney area within the first minute, reaching an average maximum of 10 to 12 per cent after 5 min, followed by a gradual decline. Contrary to expectations the increase in renal area was similar for all three contrast media, so hyperosmolality is no likely explanation of this phenomenon. None of the contrast agents caused significant changes in any of the profile components with one exception: the GGT excretion was significantly elevated during the first 24 h after diatrizoate administration as compared with the effect of saline. Light and immunofluorescence microscopy revealed no differences.

Animals↗

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Soluble contrast particles for radiographic analysis of blood flow. Determination of cardiac output in dogs.

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Animals↗

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Experimental mitral insufficiency. A new radiologic closed chest operative method.

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Animals↗

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Relief of metastatic obstruction in porta hepatis by endoprosthesis.

Percutaneous insertion of an internal endoprosthesis was attempted in 22 patients with obstructive jaundice due to metastatic lesions in the porta hepatis. The primary tumors were located outside the pancreas and the biliary tract. Insertion was successful in 16 patients. The endoprosthesis normalized the plasma bilirubin in 10 patients and improved the general condition in 12. The median survival was short when hepatic metastases were present. Insertion of an endoprosthesis is an attractive alternative to other palliative procedures.

Bilirubin↗