Comprehensive Evaluation of Human Donor Liver Viability with Polarization-Sensitive Optical Coherence Tomography

Area of Science:

• Hepatology
• Medical Imaging
• Transplantation Surgery

Background:

• Donor liver shortage critically limits liver transplantation, causing significant patient mortality.
• Current viability assessments using invasive biopsies are limited, especially for marginal organs from extended criteria donors (ECD).
• There is a critical need for comprehensive, non-invasive methods to evaluate donor liver viability.

Purpose of the Study:

• To introduce and validate polarization-sensitive optical coherence tomography (PS-OCT) for non-invasive, whole-surface assessment of donor liver viability.
• To correlate PS-OCT findings with histopathological evaluations for key hepatic parameters.
• To explore the potential of PS-OCT in expanding the donor liver pool by improving viability assessment.

Main Methods:

• PS-OCT imaging was applied to multiple regions of donor livers, aiming for near-complete surface coverage.
• Histopathological evaluations were performed and findings were cross-validated with PS-OCT data.
• Machine learning and texture analysis were used to quantify hepatic steatosis, fibrosis, inflammation, and necrosis from PS-OCT data.

Main Results:

• PS-OCT achieved near-complete surface coverage, revealing tissue heterogeneity.
• Strong correlations (≥ 80%) were established between PS-OCT derived parameters and histopathological assessments.
• Quantification of hepatic steatosis, fibrosis, inflammation, and necrosis using PS-OCT was demonstrated.

Conclusions:

• PS-OCT provides a robust, non-invasive method for assessing donor liver viability across the entire organ surface.
• This technique complements traditional pathological analysis by offering comprehensive evaluation.
• PS-OCT has the potential to decrease the discard rate of higher-risk donor livers, thereby expanding the donor pool.