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| Name | Class |
|---|---|
| Manchester University NHS Foundation Trust | OTHER_GOV |
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This study is to investigate whether it is possible to use a special type of ultrasound scan (CEUS, Contrast Enhanced Ultrasound Scan) to view the shape, assess blood supply and calculate the amount of oxygen being carried to a transplanted kidney and pancreas. We currently use a nuclear scan (Transcan) to assess this in the kidney. This is cumbersome, involves nuclear medicine and takes 45- 60 minutes to complete.
We do not routinely image the blood supply to the pancreas post-surgery, despite the most common complication post pancreas transplantation being vascular in origin. In an emergency a CT angiogram is carried out. This involves transfer of a sick patient to the CT scanner and injection of contrast which is harmful to the kidneys.
CEUS involves injection of a safe contrast prior to conducting an ultrasound scan. This can be carried out at the bed-side, provides instant results and is cheap and safe enough to do on a routine basis for all kidney and pancreas transplant recipients. Although the uses of CEUS are well recognised, it is currently not routinely used in transplantation. CEUS has been compared to other modes of imaging and has been found to be comparable/ beneficial. However, it has never been compared to Transcan. We will therefore perform CEUS on our kidney transplant recipients and compare the results to Transcan. We will also assess whether CEUS is able to visualise the blood supply to the kidney and pancreas and quantify the perfusion to the pancreas.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Kidney transplant recipients | CEUS in Kidney Transplant recipients |
| |
| Pancreas transplant recipients | CEUS in pancreas transplant recipients |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Contrast Enhanced Ultrasound Scanning | Other |
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| Measure | Description | Time Frame |
|---|---|---|
| To ensure feasibility of conducting CEUS post renal and pancreas transplantation | To ensure that conducting CEUS in the peri-operative period is logistically feasible in our centre at short-notice and it is possible to obtain images which are usable for analysis, given the presence of dressings and drains on the abdomen post surgery. | Likely to be 24 hours post surgery. |
| To assess patient acceptability of performing CEUS in the peri-operative period | A validated pain questionnaire will be completed by the patient, assessing pain scores prior to and after the CEUS, compared to prior to and after the renogram. | Likely to be within 24 hours post surgery |
| Measure | Description | Time Frame |
|---|---|---|
| Compare the quantification (likely expressed as percentage) of organ perfusion from CEUS, with our current gold standard, the nuclear renogram. | The quantification analysis of the CEUS and renograms will be correlated using descriptive statistics and either parametric or non-parametric statistical analysis to produce a correlation coefficient. | Once both, renogram and CEUS have been performed. Likely to be within 24 hours of surgery. |
| Measure | Description | Time Frame |
|---|---|---|
| Assess blood flow and morphology of the implanted pancreas | Descriptive analysis of vasculature and morphology of the implanted pancreata, high-lighting potential cause of concerns eg. thrombus, bleeding, collections | Likely to be within 24 hours post surgery |
Inclusion Criteria:
Exclusion Criteria:
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Kidney and pancreas transplant recipients
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Hussein A Khambalia, BMBS, MRCS, BMedSci | Contact | 00 (44) 1612761234 | hussein.khambalia@cmft.nhs.uk | |
| David van Dellen, MBBS, FRCS, MD | Contact | 00 (44) 1612761234 | david.vandellen@cmft.nhs.uk |
| Name | Affiliation | Role |
|---|---|---|
| Hussein A Khambalia, BMedSci, BMBS, MRCS | Manchester Royal Infirmary | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Manchester Royal Infirmary | Recruiting | Manchester | M13 9WL | United Kingdom |
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| Post-operative complications | A note of all post-operative complications, up-to discharge will be assessed. | Up-to patient discharge, likely 2 weeks |