Twenty-one percent of transplants in the US come from live donors. Data show that live-donor transplantation is a safe practice, but is not completely risk free. Malignancy and infection transmission through live organ donation is extremely rare, but can be a devastating event for the recipient, donor and treatment team if it occurs. The donor evaluation is multifactorial, taking into the account the unique medical, social and family history of individual donors, needs of the recipient, and determination of the anatomic and functional suitability of the donor organ, and is further complicated by geographical and temporal components. While balancing all practical considerations can be complex, a thorough medical assessment for infection and malignancy of potential living donor is central in protecting the donor and the intended transplant recipient.

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Each month, the American Journal of Transplantation will feature Images in Transplantation, a journal-based CME activity, chosen to educate participants on current developments in the science and imaging of transplantation. Participants can earn 1 AMA PRA Category 1 Credit ™ per article at their own pace. This month's feature article is titled: "Hematochezia: A late complication after pancreas transplantation." Accreditation and Designation StatementThis activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of John Wiley & Sons, Inc., the American Society of Transplant Surgeons, and the American Society of Transplantation. John Wiley & Sons, Inc. is accredited by the ACCME to provide continuing medical education for physicians, and fulfills the requirements for the American Board of Surgery (ABS) for Maintenance of Certification (MOC). John Wiley & Sons, Inc. designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 Credit ™ . Physicians should only claim credit commensurate with the extent of their participation in the activity. Statement of NeedGastrointestinal (GI) bleeding in pancreas transplant recipients has a wide range of etiologies. Purpose of ActivityThis activity was designed to improve patient outcomes by early recognition and appropriate management of pancreas transplant recipients presenting with GI hemorrhage. Identification of Practice GapEven with enteric drained pancreas transplants, the source of gastrointestinal bleeding is often presumed to be the native GI tract, overlooking etiologies related to the transplant pancreas that can be life-threatening. Learning ObjectivesUpon completion of this educational activity, participants will be able to: • Create a differential diagnosis of acute GI bleeding for pancreas transplant recipients.• Recognize the diagnostic difficulties in assessing disorders of the donor duodenum.• Apply the strategies learned from this activity to pancreas transplant recipients in the prevention of GI complications and the management of those who present with GI hemorrhage. Target Audience This activity has been designed to meet the educational needs of physicians and surgeons in the field of transplantation. Disclosures No commercial support has been accepted related to the development or publication of this activity. John Wiley & Sons, Inc. has reviewed all disclosures and resolved or managed all identified conflicts of interest, as applicable.