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

Daqing Piao; Alan Hawxby M.D.; Harlan Wright M.D.; Erin M. Rubin M.D.

doi:10.1117/1.JBO.23.8.080601

29 August 2018 Perspective review on solid-organ transplant: needs in point-of-care optical biomarkers

Daqing Piao, Alan Hawxby M.D., Harlan Wright M.D., Erin M. Rubin M.D.

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Journal of Biomedical Optics, Vol. 23, Issue 8, 080601 (August 2018). https://doi.org/10.1117/1.JBO.23.8.080601

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.

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Daqing Piao, Alan Hawxby M.D., Harlan Wright M.D., and Erin M. Rubin M.D. "Perspective review on solid-organ transplant: needs in point-of-care optical biomarkers," Journal of Biomedical Optics 23(8), 080601 (29 August 2018). https://doi.org/10.1117/1.JBO.23.8.080601

Received: 23 June 2018; Accepted: 2 August 2018; Published: 29 August 2018

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