Human donor liver viability evaluation with polarization-sensitive optical coherence tomography.

Area of Science:

• Medical Imaging
• Transplantation Science
• Biomedical Engineering

Background:

• Donor liver shortage limits human liver transplantation.
• Marginal livers from extended criteria donors are increasingly utilized.
• Current viability assessment relies on invasive biopsy, necessitating noninvasive methods.

Purpose of the Study:

• To introduce polarization-sensitive optical coherence tomography (PS-OCT) for multiparameter donor liver viability assessment.
• To evaluate PS-OCT's ability to noninvasively quantify hepatic parameters across the entire liver surface.
• To correlate PS-OCT findings with histopathology, ex vivo perfusion, and clinical transplant outcomes.

Main Methods:

• PS-OCT imaging was performed on multiple regions of human donor livers.
• Histopathological evaluations served as the gold standard for cross-validation.
• Machine learning and texture analysis were employed to quantify steatosis, fibrosis, inflammation, and necrosis.

Main Results:

• PS-OCT showed >80% correlation with histopathological assessments of liver steatosis, fibrosis, inflammation, and necrosis.
• PS-OCT findings strongly correlated with donor liver functional performance during normothermic machine perfusion.
• PS-OCT results demonstrated significant correlations with clinical liver transplant outcomes.

Conclusions:

• PS-OCT offers a noninvasive, comprehensive assessment of donor liver viability.
• This technique effectively complements traditional pathological analysis, potentially reducing high-risk liver discard.
• PS-OCT could expand the donor pool and improve the safety of liver transplantation.