Duke University, Department of Biomedical Engineering, Durham, North Carolina, United States.
Duke University Medical Center, Duke Transplant Center, Department of Surgery, Durham, United States.
J Biomed Opt. 2021 Sep;26(9). doi: 10.1117/1.JBO.26.9.096008.
The current gold standard for monitoring small intestinal transplant (IT) rejection is endoscopic visual assessment and biopsy of suspicious lesions; however, these lesions are only superficially visualized by endoscopy. Invasive biopsies provide a coarse sampling of tissue health without depicting the true presence and extent of any pathology. Optical coherence tomography (OCT) presents a potential alternative approach with significant advantages over traditional white-light endoscopy.
The aim of our investigation was to evaluate OCT performance in distinguishing clinically relevant morphological features associated with IT graft failure.
OCT was applied to evaluate the small bowel tissues of two rhesus macaques that had undergone IT of the ileum. The traditional assessment from routine histological observation was compared with OCT captured using a handheld surgical probe during the days post-transplant and subsequently was compared with histophaology.
The reported OCT system was capable of identifying major biological landmarks in healthy intestinal tissue. Following IT, one nonhuman primate (NHP) model suffered a severe graft ischemia, and the second NHP graft failed due to acute cellular rejection. OCT images show visual evidence of correspondence with histological signs of IT rejection.
Results suggest that OCT imaging has significant potential to reveal morphological changes associated with IT rejection and to improve patient outcomes overall.
目前监测小肠移植（IT）排斥反应的金标准是内镜视觉评估和可疑病变的活检；然而，这些病变仅通过内镜进行表面可视化。有创活检提供了组织健康的粗略样本，而无法描绘任何病理学的真实存在和程度。光学相干断层扫描（OCT）提供了一种潜在的替代方法，与传统的白光内镜相比具有显著优势。
我们的研究旨在评估 OCT 在区分与 IT 移植物失败相关的临床相关形态特征方面的性能。
OCT 用于评估接受回肠 IT 的两只恒河猴的小肠组织。将传统的常规组织学观察评估与移植后几天使用手持手术探头捕获的 OCT 进行比较，并随后与组织病理学进行比较。
报告的 OCT 系统能够识别健康肠组织中的主要生物学标志。在 IT 之后，一只非人类灵长类动物（NHP）模型发生严重移植物缺血，第二只 NHP 移植物因急性细胞排斥反应而失败。OCT 图像显示与 IT 排斥的组织学迹象相对应的视觉证据。
结果表明，OCT 成像具有揭示与 IT 排斥相关的形态变化并整体改善患者预后的巨大潜力。
