期刊
TRANSPLANT INTERNATIONAL
卷 34, 期 4, 页码 709-720出版社
FRONTIERS MEDIA SA
DOI: 10.1111/tri.13823
关键词
deceased donation; fatty liver disease; hepatic steatosis; liver transplantation outcomes; medical device
资金
- Evelyn Trust
- National Institute for Health Research (NIHR) Blood and Transplant Research Unit (NIHR BTRU) in Organ Donation and Transplantation at the University of Cambridge
- Newcastle University
- NHS Blood and Transplant (NHSBT)
- NIHR Academic Clinical Lectureship
- NIHR Cambridge Biomedical Research Centre
This study demonstrates the feasibility of real-time measurement of optical backscatter in donor livers, with early results indicating readings correlate with steatosis and may provide insights into graft outcomes such as early allograft dysfunction and graft loss.
Transplantation of severely steatotic donor livers is associated with early allograft dysfunction and poorer graft survival. Histology remains the gold standard diagnostic of donor steatosis despite the lack of consensus definition and its subjective nature. In this prospective observational study of liver transplant patients, we demonstrate the feasibility of using a handheld optical backscatter probe to assess the degree of hepatic steatosis and correlate the backscatter readings with clinical outcomes. The probe is placed on the surface of the liver and emits red and near infrared light from the tip of the device and measures the amount of backscatter of light from liver tissue via two photodiodes. Measurement of optical backscatter (Mantel-Cox P < 0.0001) and histopathological scoring of macrovesicular steatosis (Mantel-Cox P = 0.046) were predictive of 5-year graft survival. Recipients with early allograft dysfunction defined according to both Olthoff (P = 0.0067) and MEAF score (P = 0.0097) had significantly higher backscatter levels from the donor organ. Backscatter was predictive of graft loss (AUC 0.75, P = 0.0045). This study demonstrates the feasibility of real-time measurement of optical backscatter in donor livers. Early results indicate readings correlate with steatosis and may give insight to graft outcomes such as early allograft dysfunction and graft loss.
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