Pediatric Transplant Interventions.

Autor: Sharma P; Medical College of Georgia, Augusta University, Augusta, GA., Shah R; Seth G.S Medical College and K.E.M Hospital, Mumbai, Maharashtra, India., Zavaletta V; Department of Radiology, Children's Hospital Colorado, University of Colorado School of Medicine, Aurora, CO., Bertino F; Department of Radiology, Interventional Radiology Section, NYU Langone Health/NYU Grossman School of Medicine, New York, NY., Sankhla T; Department of Radiology and Imaging Sciences, Division of Interventional Radiology and Image Guided Medicine, Emory University School of Medicine, Atlanta, GA., Kim JM; Department of Radiology and Imaging Sciences, Division of Interventional Radiology and Image Guided Medicine, Emory University School of Medicine, Atlanta, GA., Leshen M; Department of Radiology, Division of Interventional Radiology, Children's Healthcare of Atlanta, Atlanta, GA., Shah J; Department of Radiology, Division of Interventional Radiology, Children's Healthcare of Atlanta, Atlanta, GA; Department of Radiology and Imaging Sciences, Division of Interventional Radiology and Image Guided Medicine, Emory University School of Medicine, Atlanta, GA. Electronic address: jay.shah@emory.edu.
Jazyk: angličtina
Zdroj: Techniques in vascular and interventional radiology [Tech Vasc Interv Radiol] 2023 Dec; Vol. 26 (4), pp. 100930. Date of Electronic Publication: 2023 Nov 04.
DOI: 10.1016/j.tvir.2023.100930
Abstrakt: 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.
(Copyright © 2023. Published by Elsevier Inc.)
Databáze: MEDLINE
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