Biomedical Engineering Group, Department of Applied Mechanics, Indian Institute of Technology Madras, Chennai, India; Department of Biomedical Engineering, Sri Sivasubramaniya Nadar College of Engineering, Kalavakkam, Chengalpattu, India.
The Institute of Liver Disease & Transplantation, Dr Rela Institute & Medical Centre, Bharath Institute of Higher Education & Research, Chennai, India.
J Gastrointest Surg. 2024 Jun;28(6):799-804. doi: 10.1016/j.gassur.2024.02.033. Epub 2024 Feb 29.
Quantification of macrosteatosis (MS) in the liver is important given that it has shown to directly correlate with adverse post-liver transplant (LT) outcomes. With advances in medical technology and an implicit understanding of pathology, noninvasive methods of quantitatively assessing MS are in various stages of development. Each of these methods is based on the physical principles of differences between a fat-laden hepatocyte and a normal one.
In this regard, after a proof-of-concept study on a prototype for a simple, real-time, handheld device using the principle of diffuse reflectance spectroscopy, this study presents an upgraded point-of-care (POC) device for the noninvasive assessment of hepatic MS in liver donors.
The device was validated on cohort of donor livers and showed a sensitivity (0.0021 V/% fat) and highly correlated (r = 0.9868, P < .0001) with gold-standard liver biopsy. Results showed that this upgraded POC device provides a reliable method for the noninvasive assessment of hepatic MS, which is crucial for selecting suitable donor livers for LT.
The device has the potential to be an invaluable apparatus at the hands of the organ-retrieving surgeon. It is noninvasive, portable (handheld), and economic; provides real-time readings of the percentage of MS; and can be efficaciously handled by any member of the organ-retrieving team.
肝内脂肪变性（MS）的定量分析很重要，因为它已经被证明与肝移植（LT）后的不良预后直接相关。随着医学技术的进步和对病理学的深入理解，定量评估 MS 的非侵入性方法正在不同阶段的开发中。这些方法中的每一种都是基于富含脂肪的肝细胞与正常肝细胞之间物理原理的差异。
在使用漫反射光谱原理对简单、实时、手持式原型设备进行概念验证研究之后，本研究提出了一种升级的即时护理（POC）设备，用于非侵入性评估肝供体的肝内 MS。
该设备在供体肝脏队列中进行了验证，显示出与金标准肝活检高度相关的灵敏度（0.0021 V/%脂肪）（r = 0.9868，P <.0001）。结果表明，这种升级的 POC 设备为非侵入性评估肝内 MS 提供了一种可靠的方法，这对于选择适合 LT 的供体肝脏至关重要。
该设备有望成为器官采集外科医生手中非常有价值的仪器。它是非侵入性、便携式（手持式）和经济实惠的；可实时读取 MS 的百分比读数；并且可以由器官采集团队的任何成员有效地处理。
