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J Biomed Opt. 2018 Aug;23(8):1-14. doi: 10.1117/1.JBO.23.8.080601.

Perspective review on solid-organ transplant: needs in point-of-care optical biomarkers.

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Oklahoma State University, School of Electrical and Computer Engineering, Stillwater, Oklahoma, United States.
Oklahoma State University, Department of Veterinary Clinical Sciences, Center for Veterinary Health, United States.
University of Oklahoma Health Sciences Center, Oklahoma Transplant Center, Oklahoma City, Oklahoma, United States.
University of Oklahoma Health Sciences Center, Department of Pathology, Oklahoma City, Oklahoma, United States.


Solid-organ transplant is one of the most complex areas of modern medicine involving surgery. There are challenging opportunities in solid-organ transplant, specifically regarding the deficiencies in pathology workflow or gaps in pathology support, which may await alleviations or even de novo solutions, by means of point-of-care, or point-of-procedure optical biomarkers. Focusing the discussions of pathology workflow on donor liver assessment, we analyze the undermet need for intraoperative, real-time, and nondestructive assessment of the donor injuries (such as fibrosis, steatosis, and necrosis) that are the most significant predictors of post-transplant viability. We also identify an unmet need for real-time and nondestructive characterization of ischemia or irreversible injuries to the donor liver, earlier than appearing on morphological histology examined with light microscopy. Point-of-procedure laparoscopic optical biomarkers of liver injuries and tissue ischemia may also facilitate post-transplant management that is currently difficult for or devoid of pathological consultation due to lack of tools. The potential and pitfalls of point-of-procedure optical biomarkers for liver assessment are exemplified in breadth for steatosis. The more general and overarching challenges of point-of-procedure optical biomarkers for liver transplant pathology, including the shielding effect of the liver capsule that was quantitated only recently, are projected. The technological and presentational benchmarks that a candidate technology of point-of-procedure optical biomarkers for transplant pathology must demonstrate to motivate clinical translation are also foreseen.


fibrosis; optical biomarker; optical spectroscopy; point-of-care; solid-organ transplant; steatosis


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