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Contrast-enhanced computed tomography for ex vivo assessment of human kidneys: A proof-of-concept study
Alborz Feizi1,2, Jenna R DiRito1, Owen Richfield2
1Department of Surgery, Yale School of Medicine, New Haven, Connecticut, USA.
Background:
Ex vivo perfusion of transplant-declined human organs has emerged as a promising platform to study the response of an organ to novel therapeutic strategies. However, to fully realize the capability of this platform for performing translational research in human organ pathophysiology, there is a need for robust assays to assess organ function and disease. State-of-the-art research methods rely on analyses of biopsies taken during perfusion, which both damages the organ and only provides localized information. Developing non-invasive, whole organ methods of assessment is critical to the further development of this research platform.
Methods:
We use ex vivo cold infusion scanning (EXCIS) with contrast-enhanced computed tomography (CT) to quantify perfusion in kidneys preserved ex vivo. EXCIS-CT computes three complementary metrics for whole organ assessment: a dynamic assessment of contrast filling, a measure of vascular network anatomical structure, and a static assessment of perfusion heterogeneity.
Results:
These metrics were applied to a series of six transplant-declined human kidneys, which demonstrated a range of anatomies and perfusion. Lastly, two transplant-declined human kidneys were imaged before and after a 1-h period of ex vivo normothermic perfusion (NMP). We found variable responses to NMP, with one kidney maintaining the vascular network and hemodynamics and the other showing significant changes in vessel size and spatial perfusion profile.
Conclusions:
EXCIS-CT provides metrics that can be used to characterize whole organ perfusion and vascular function.
Insights
Ex vivo cold infusion scanning with computed tomography (EXCIS-CT) non-invasively assesses whole human kidney perfusion. This method provides critical metrics for evaluating organ function and vascular health during ex vivo perfusion research.
Area of Science:
- Organ transplantation research
- Medical imaging techniques
- Translational medicine
Background:
- Ex vivo perfusion of human organs is a key platform for studying therapeutic responses.
- Current methods using biopsies are invasive and provide localized data.
- Developing non-invasive, whole-organ assessment tools is crucial for advancing translational research.
Purpose of the Study:
- To develop and validate a non-invasive method for assessing whole organ perfusion in human kidneys.
- To establish robust assays for evaluating organ function and disease during ex vivo perfusion.
Main Methods:
- Utilized ex vivo cold infusion scanning (EXCIS) with contrast-enhanced computed tomography (CT).
- EXCIS-CT quantifies whole organ perfusion through dynamic contrast filling, vascular anatomical structure, and perfusion heterogeneity.
- Applied these metrics to six transplant-declined human kidneys.
Main Results:
- Demonstrated a range of anatomical variations and perfusion characteristics in the studied kidneys.
- Observed variable responses to ex vivo normothermic perfusion (NMP) in two kidneys.
- One kidney maintained vascular integrity and hemodynamics post-NMP, while the other showed significant changes.
Conclusions:
- EXCIS-CT offers a non-invasive approach to characterize whole organ perfusion.
- The developed metrics are valuable for assessing vascular function in ex vivo perfused human organs.
