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PART 5 — ABDOMINAL
SUMMARY
Sonography plays an important part in evaluating both renal and liver transplants and is usually the initial imaging modality of choice for evaluating the transplant patient. It is important for the sonographer to review the operative notes or to talk to the surgeon so that the anatomy and anastomotic sites encountered during the examination are understood. The sonographer should adjust the various Doppler controls to optimize the detection of flow for each specific vessel, changing controls as needed according to the flow dynamics of the specific vessel being interrogated. Performing an adequate and thorough examination is vital for the care of these pa- tients and has enormous impact in both graft and patient survival.
Critical Thinking Questions
1. The transplant surgeon calls down requesting a STAT ultrasound on his patient who now has decreased urinary output. Is this really an emergency? Why or why not?
2. A patient returns to ultrasound for a follow-up renal transplant sonogram. The patient informs you that he had a renal transplant biopsy 2 days ago. What should the sonographer be looking for as he or she obtains the images?
3. What is the significance of an elevated RI in a renal transplant?
4. Why is it important for the sonographer to review the operative notes before performing an examination of any transplanted organ?
5. Why is it normal to have an elevated RI in the hepatic artery in the immedi- ate postop liver transplant patient?
6. What would be some unusual vascular findings of the portal vein in a patient with a liver transplant as opposed to a patient with a nontransplanted liver?
REFERENCES
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