National Organ Retrieval Imaging System: results of the pilot study

Efficient utilization of marginal liver grafts is dependant on the accurate assessment and relay of graft-related information to recipient units in an organ-sharing network. Currently, information is conveyed by the recovery team over the telephone and can sometimes be inconclusive or incomplete. We have developed a web-based instrument called the National Organ Retrieval Imaging System (NORIS) to improve this assessment process. The aim of this pilot study was to assess the feasibility of real-time data upload and the reliability of web-based remote assessment in identifying donor livers with significant macro-steatosis. Data from 153 donor livers uploaded to the website were analysed. Completeness of graft data uploads, accuracy of on-site and two separate remote assessments using a semi-objective graft score in identifying grafts with moderate or severe macro-vesicular steatosis were analysed. Uploads were complete in all recoveries. Liver grafts with moderate or severe macro-vesicular steatosis had a higher incidence of initial poor function (7/10 vs. 26/86, P = 0.029). Organ scores for steatotic grafts were significantly higher than nonsteatotic grafts in all three assessments (P < 0.001). Accuracy of the two remote assessors was similar to the actual on-site assessment. There was a substantial degree of inter-observer agreement between the assessments (kappa statistics = 0.658, 0.597, 0.698). Feasibility of real-time data upload and reliability of remote graft assessment have been confirmed.