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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.

Author information

1
Oklahoma State University, School of Electrical and Computer Engineering, Stillwater, Oklahoma, United States.
2
Oklahoma State University, Department of Veterinary Clinical Sciences, Center for Veterinary Health, United States.
3
University of Oklahoma Health Sciences Center, Oklahoma Transplant Center, Oklahoma City, Oklahoma, United States.
4
University of Oklahoma Health Sciences Center, Department of Pathology, Oklahoma City, Oklahoma, United States.

Abstract

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.

KEYWORDS:

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

PMID:
30160078
DOI:
10.1117/1.JBO.23.8.080601

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