[en] Postoperative complications seriously threaten graft and patient survival. Prompt diagnosis and treatment of these complications is of critical importance. In clinical differentiation of rejection from hepatic dysfunctions such as biliary obstruction, studies of allograft perfusion and bile flow with radionuclides are helpful. Cholescinti-graphy is specially used to diagnose bile leakage. Focal fluid collections such as biliomas, hematomas and seromas are seen with relative frequency after liver transplantation. Directed fine needle aspiration differentiates all these cases and is able to document infection. (author). 25 refs.; 5 figs.; 1 tab

No abstract available

[en] The authors studied with duplex-Doppler US28 renal transplant recipients in 31 clinically different episodes, during the early postoperative period. Morphological data were thus obtained, as well as hemodinamic information. According to the literature on the subject, a pulsatility index (PI) >1.5 was considered as abnormal. US diagnosis was retrospectively compared with final clinical diagnosis and with response to therapy. In one case, the kidney was surgically removed. We evaluated US sensitivity and specificity in the diagnosis of acute rejection with real-time US, Doppler alone and combined with duplex. A PI ≥1.5 corresponded to acute rejection, with 60% sensitivity and 85.7% specificity. With a PI >1.8, sensitivity decreased to 50%, but specificity increased to100%. The severest changes in Doppler waveform had a bad prognostic significance. Besides poor specificity- which is so often emphasized in literature- our results chiefly demonstrated sensitivity limitations, partly corrigible with a real-time US signs, together with Doppler PI (sensitivity: 90%, specificity: 85.7%). Duplex-Doppler US, in spite of its well-known limitations, remains therefore a simple, rather reliable and non-invasive technique to study renal transplant complications

[en] Short communication. (Author)

No abstract available

[en] Short communication

[en] Blood products irradiation with ionizing radiation is used to prevent transfusion associated graft-versus-host disease (TA-GVHD) during blood transfusion. Many radiotherapy departments worldwide developed institutional techniques depending on the available radiotherapy equipment and conditions. The aim of this work is to report an irradiation technique for blood products developed at the Radiotherapy Department at the University Hospital 'St. Marina', using linear accelerator for the needs of the Transplant center of the same hospital. High-energy X-rays from a multimodal linear accelerator are used. Blood products are placed in a box and covered with rice. A reproducible geometry of the linear accelerator Clinical iX, Varian, was selected. The dosimetry plan for the irradiation of blood products was calculated to achieve a homogeneous distribution of the absorbed dose. The developed technique offers an unified procedure for blood products irradiation. The choice of water-equivalent rice medium fulfils the condition of dose built-up effect. The treatment plan ensures that blood products receive minimum irradiation dose of 25 Gy. The reported technique is effective with regard to the dose required to prevent the risk of developing TA-GVHD, using the maximum capacity of the available equipment without a need for new investments and no obstruction of the clinical work flow with patients. This is the first reported technique in the country for irradiation of blood products with a linear accelerator.

[en] A radionuclide method was developed to evaluate a local GVH reaction. 5-20x10₆ mononuclear cells prepared from 15 healthy blood donors were injected into the abdominal skin of 15 partially immunosuppressed rats. 48 hours later, 0.5 mCi of [Tc-99m] sodium pertechnetate was injected and local GVH reactions were evaluated from nodules on inverted skins that were imaged and analyzed by a portable gamma camera interfaced with mini computer. There was an excellent visualization of positive GVH reaction with greater than 5x10₆ mononuclear cells, and there was also good correlation between inoculated cell numbers and radioactive count density ratios, providing objective standardization for the grading of positive reactions

[en] Our aim is to report the computed tomography (CT) features of the long-term failed renal allograft. Ten patients with failed renal transplants in whom the graft was left in situ underwent CT for various unrelated indications. The majority of the failed grafts showed marked shrinkage and coarse punctate diffuse parenchymal calcifications. Small cysts were seen in four grafts. A long-term failed renal transplant appeared on CT as a small rounded soft tissue mass. The graft was almost always heavily calcified. Lack of awareness of the nature of such a mass may mislead the radiologist in interpreting it as a space-occupying lesion

[en] Thallium-201 myocardial imaging was performed in seven long-term cardiac transplant survivors who were undergoing selective coronary arteriography as a screening test for immune mediated coronary atherosclerosis. The radionuclide studies showed fixed defects in all patients, though none was known to have had a myocardial infarction. Such abnormalities may be due to previous rejection episodes. Reversible ('ischaemic') defects were present in two patients with triple vessel disease, and were also seen in three subjects with minor (< 50% liminal diameter) stenosis. Ischaemic thallium-201 defects in cardiac transplant recipients indicate the presence of coronary artery disease, though the stenosis may be of a degree which would normally be considered haemodynamically non-significant. The possible role of small vessel disease in producing these defects is discussed. (author)