Pediatric Transplant Interventions

IF 1.4 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
Pareena Sharma , Ritu Shah , Vaz Zavaletta MD, PhD , Frederic Bertino MD , Tina Sankhla , Jun Man Kim , Michael Leshen , Jay Shah
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引用次数: 0

Abstract

The field of pediatric organ transplantation has grown significantly in recent decades, with interventional radiology (IR) playing an essential role in managing pre and post-transplant complications. Pediatric transplant patients face unique challenges compared to adults, including donor-recipient size mismatch, and complications of a growing child with changing physiology. Interventional radiologists play a major role in pediatric renal and liver transplant. IR interventions begin early in the child's pretransplant journey, with diagnostic procedures such as biopsies, angiograms, and cholangiograms. These procedures are essential for understanding the etiology of organ failure and identifying potential transplant candidates. Minimally invasive therapeutic procedures may serve as bridges to transplant and may include vascular access optimization for hemodialysis, transjugular intrahepatic portosystemic shunts (TIPS) creation, and tumor embolization or ablation. After transplant, image-guided biopsies for the surveillance of graft rejection and treatment of vascular or luminal stenoses, pseudoaneurysms, and anastomotic leaks can maintain the function and longevity of the transplant organ. Careful consideration must be given to patient size and evolving anatomy, radiation exposure, and the need for deeper sedation for pediatric patients. Despite these challenges, the integration of IR in pediatric transplant care has proven beneficial, offering minimally invasive alternatives to surgery, faster recovery times, and improved outcomes.

小儿移植干预
近几十年来,儿科器官移植领域取得了长足发展,介入放射学(IR)在处理移植前后并发症方面发挥了重要作用。与成人相比,儿科移植患者面临着独特的挑战,包括供体与受体大小不匹配,以及因儿童生长发育和生理变化而产生的并发症。介入放射科医生在小儿肾脏和肝脏移植中发挥着重要作用。介入放射治疗在儿童移植前的早期就已开始,包括活组织检查、血管造影和胆管造影等诊断程序。这些程序对于了解器官衰竭的病因和确定潜在的移植候选者至关重要。微创治疗程序可作为通往移植的桥梁,包括优化血液透析的血管通路、创建经颈静脉肝内门体分流术(TIPS)以及肿瘤栓塞或消融术。移植后,通过图像引导活检监测移植排斥反应,治疗血管或管腔狭窄、假性动脉瘤和吻合口漏,可以保持移植器官的功能和寿命。必须慎重考虑患者的体型和不断变化的解剖结构、辐射暴露以及对儿童患者进行深度镇静的必要性。尽管存在这些挑战,但事实证明,将红外技术整合到儿科移植护理中是有益的,它提供了手术的微创替代方案,缩短了恢复时间,改善了治疗效果。
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来源期刊
Techniques in Vascular and Interventional Radiology
Techniques in Vascular and Interventional Radiology RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING-
CiteScore
2.70
自引率
0.00%
发文量
47
期刊介绍: Interventional radiology is an area of clinical diagnosis and management that is highly technique-oriented. Therefore, the format of this quarterly journal, which combines the visual impact of an atlas with the currency of a journal, lends itself perfectly to presenting the topics. Each issue is guest edited by a leader in the field and is focused on a single clinical technique or problem. The presentation is enhanced by superb illustrations and descriptive narrative outlining the steps of a particular procedure. Interventional radiologists, neuroradiologists, vascular surgeons and neurosurgeons will find this a useful addition to the clinical literature.
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