Multi-Modality Medical Imaging Group, TechMed Centre, University of Twente, Enschede, Netherlands.
Engineering Organ Support Technologies Group, Department of Biomechanical Engineering, University of Twente, Enschede, Netherlands.
Transpl Int. 2024 Sep 4;37:12827. doi: 10.3389/ti.2024.12827. eCollection 2024.
Machine perfused organs offer an excellent experimental platform, e.g., for studying organ physiology and for conducting pre-clinical trials for drug delivery. One main challenge in machine perfusion is the accurate assessment of organ condition. Assessment is often performed using viability markers, i.e., lactate concentrations and blood gas analysis. Nonetheless, existing markers for condition assessment can be inconclusive, and novel assessment methods remain of interest. Over the last decades, several imaging modalities have given unique insights into the assessment of organ condition. A systematic review was conducted according to accepted guidelines to evaluate these medical imaging methods, focussed on literature that use machine perfused human-sized organs, that determine organ condition with medical imaging. A total of 18 out of 1,465 studies were included that reported organ condition results in perfused hearts, kidneys, and livers, using both conventional viability markers and medical imaging. Laser speckle imaging, ultrasound, computed tomography, and magnetic resonance imaging were used to identify local ischemic regions and quantify intra-organ perfusion. A detailed investigation of metabolic activity was achieved using P magnetic resonance imaging and near-infrared spectroscopy. The current review shows that medical imaging is a powerful tool to assess organ condition.
机器灌注器官提供了一个极好的实验平台，例如，用于研究器官生理学和进行药物输送的临床前试验。机器灌注的一个主要挑战是准确评估器官状况。评估通常使用生存力标志物（即乳酸浓度和血气分析）进行。尽管如此，现有的状况评估标志物可能没有定论，新的评估方法仍然受到关注。在过去几十年中，几种成像方式为评估器官状况提供了独特的见解。根据公认的指南进行了系统评价，以评估这些医学成像方法，重点是使用机器灌注的人体大小的器官，使用医学成像确定器官状况的文献。共有 18 项研究从 1465 项研究中脱颖而出，报告了灌注心脏、肾脏和肝脏的器官状况结果，同时使用了传统的生存力标志物和医学成像。激光散斑成像、超声、计算机断层扫描和磁共振成像用于识别局部缺血区域和量化器官内灌注。使用 P 磁共振成像和近红外光谱技术对代谢活性进行了详细研究。目前的综述表明，医学成像是评估器官状况的有力工具。
