Acute complications after hematopoietic stem cell transplantations – a radiological perspective

Background: The number of stem cell transplants for hematologic malignancies has doubled since 2000 and continues to rise. Acute complications within the first 100 days post-transplant are linked to high morbidity and mortality of up to 30%. Since all organ systems can be affected and symptoms may be subtle, imaging plays a central role in early detection and monitoring of these complications. In response to increasing transplant numbers, expanding indications, and rapid therapeutic advances, the European Society for Blood and Marrow Transplantation (EBMT) revised its handbook in 2024. Most existing reviews on imaging acute complications post-transplant are five to ten years old. This article aims to provide an updated overview for radiologists increasingly confronted with acute complications after stem cell transplantation. Method: The structure of this systematic review follows the updated EBMT Handbook. A systematic search was conducted in the PUBMED database to identify original studies on imaging of acute post-transplant complications from the past five years. A supplementary selective search helped to integrate the findings into the EBMT-handbook-aligned framework. A total of 29 original studies published in the last five years were included, providing new insights into imaging of acute complications post-HSCT. Conclusion: This review offers a concise overview of typical acute organ-specific complications following stem cell transplantation and highlights recent advances in imaging. Key Points: · Acute complications after stem cell transplantation are still associated with high mortality.. · Imaging is essential for early diagnosis and management.. · This review presents an updated, guideline-based overview of typical acute post-transplant complications.. Citation Format: · Brandt J, Helfen A. Acute complications after hematopoietic stem cell transplantations - a radiological perspective. Rofo 2026; DOI 10.1055/a-2787-4646.