Contrast-enhanced computed tomography for ex vivo assessment of human kidneys: A proof-of-concept study.

Autor: Feizi A; Department of Surgery, Yale School of Medicine, New Haven, Connecticut, USA.; Department of Biomedical Engineering, Yale University, New Haven, Connecticut, USA., DiRito JR; Department of Surgery, Yale School of Medicine, New Haven, Connecticut, USA., Richfield O; Department of Biomedical Engineering, Yale University, New Haven, Connecticut, USA., Stendahl JC; Yale Translational Research Imaging Center, New Haven, Connecticut, USA.; Department of Medicine (cardiology), Yale School of Medicine, New Haven, Connecticut, USA., Harris M; Department of Surgery, Yale School of Medicine, New Haven, Connecticut, USA., Spindler S; Department of Surgery, Yale School of Medicine, New Haven, Connecticut, USA., Edwards CM; Department of Surgery, Yale School of Medicine, New Haven, Connecticut, USA., Lysyy T; Department of Surgery, Yale School of Medicine, New Haven, Connecticut, USA., Lee SR; Department of Surgery, Yale School of Medicine, New Haven, Connecticut, USA.; Yale Translational Research Imaging Center, New Haven, Connecticut, USA., Boutagy NE; Yale Translational Research Imaging Center, New Haven, Connecticut, USA.; Department of Medicine (cardiology), Yale School of Medicine, New Haven, Connecticut, USA., Feher A; Yale Translational Research Imaging Center, New Haven, Connecticut, USA.; Department of Medicine (cardiology), Yale School of Medicine, New Haven, Connecticut, USA., Yoo P; Department of Surgery, Yale School of Medicine, New Haven, Connecticut, USA., Hosgood SA; Department of Surgery, University of Cambridge, Cambridge, UK., Mulligan DC; Department of Surgery, Yale School of Medicine, New Haven, Connecticut, USA., Nicholson ML; Department of Surgery, University of Cambridge, Cambridge, UK., Sinusas AJ; Department of Biomedical Engineering, Yale University, New Haven, Connecticut, USA.; Yale Translational Research Imaging Center, New Haven, Connecticut, USA.; Department of Medicine (cardiology), Yale School of Medicine, New Haven, Connecticut, USA.; Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, Connecticut, USA., Haakinson DJ; Department of Surgery, Yale School of Medicine, New Haven, Connecticut, USA., Tietjen GT; Department of Surgery, Yale School of Medicine, New Haven, Connecticut, USA.; Department of Biomedical Engineering, Yale University, New Haven, Connecticut, USA.
Jazyk: angličtina
Zdroj: Artificial organs [Artif Organs] 2024 Dec; Vol. 48 (12), pp. 1536-1548. Date of Electronic Publication: 2024 Aug 27.
DOI: 10.1111/aor.14840
Abstrakt: 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.
(© 2024 International Center for Artificial Organ and Transplantation (ICAOT) and Wiley Periodicals LLC.)
Databáze: MEDLINE
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