Abstract
BackgroundThe transplantation process usually takes place without transplant teams being able to use imaging data to assess graft quality. The decision of whether to go get the graft or not is therefore limited and suboptimal. “Cristal images” is a teleimaging project allowing real-time visualization of images of the organs of the donor. The objective of our study is to assess whether the use of a secure teleimaging can improve the effectiveness and efficiency of the procurement and transplantation processes.MethodsWe will use the exhaustive national registry of organ allocation and transplantation, and compare outcomes before the deployment of “Cristal images” (years 2015–2016) and after it becomes operational (years 2018–2019) for heart, lung, liver and kidney transplant in a before-after study, combined with a preference elicitation study. The primary endpoint will be the number of successful organ transplantations. Secondary endpoints will be related to the efficiency of the transplant process (decision making, transportation, cost) and a preference elicitation study will determine the relative preferences of transplant teams towards few “Cristal images”’ components or potential developments, which are yet to be determined through a qualitative analysis based on interviews with professionals.DiscussionThis study will provide stakeholders data on the efficiency of real-time visualization for transplant teams and identify the levers likely to influence the technology use among these teams.Trial registrationclinicaltrials.gov: NCT03201224, 13 June 2017, retrospectively registered.
Highlights
The transplantation process usually takes place without transplant teams being able to use imaging data to assess graft quality
Without the possibility of image transmission between the procurement and the transplant teams, decisions are made without any assessment of organ anatomy by the transplant teams
Revealed preference methods are based on the observation of actual utilization patterns; these methods are not applicable here, especially because our objective is to study how actual preferences relate to advisable evolutions of “Cristal Images”
Summary
The transplantation process usually takes place without transplant teams being able to use imaging data to assess graft quality. The objective of our study is to assess whether the use of a secure teleimaging can improve the effectiveness and efficiency of the procurement and transplantation processes. Improving organ procurement remains a challenge with the increasing age (almost 58 years) and associated co-morbidities of deceased donors resulting in “extended criteria” transplants [1]. The two major steps of the transplant process are 1) the evaluation by the donor procurement teams, and 2) proposal to the transplant teams, according to national allocation rules. Without the possibility of image transmission between the procurement and the transplant teams, decisions are made without any assessment of organ anatomy by the transplant teams. If the graft is ill-suited to their patient’s anatomy, the team has to relinquish the graft, which increases the risk of organ necrosis and loss due to prolonged ischemia
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