Optical coherence tomography of the living human kidney

Peter M Andrews,Jeremiah Wierwille,Jennifer Verbesey,Hsing-Wen Wang,Matthew Cooper,Yu Chen,Wei Gong

doi:10.1142/s1793545813500648

Abstract

Acute tubular necrosis (ATN) induced by ischemia is the most common insult to donor kidneys destined for transplantation. ATN results from swelling and subsequent damage to cells lining the kidney tubules. In this study, we demonstrate the capability of optical coherence tomography (OCT) to image the renal microstructures of living human donor kidneys and potentially provide a measure to determine the extent of ATN. We also found that Doppler-based OCT (i.e., DOCT) reveals renal blood flow dynamics that is another major factor which could relate to post-transplant renal function. All OCT/DOCT observations were performed in a noninvasive, sterile and timely manner on intact human kidneys both prior to (ex vivo) and following (in vivo) their transplantation. Our results indicate that this imaging model provides transplant surgeons with an objective visualization of the transplant kidneys prior and immediately post transplantation.

Highlights

Acute tubular necrosis (ATN), caused by a lack of oxygen to the kidney, is one of the most common causes of kidney failure.It is a critical factor in determining the status of a kidney destined for transplantation
It has been shown that noninvasive imaging techniques [i.e., tandem scanning confocal microscopy (TSCM)] could be used to determine the degree of ATN by analyzing the supercial nephrons of living rabbit kidneys and that these observations correlate with post-transplant renal function.[1]
We demonstrate the ability of Optical coherence tomography (OCT)/Doppler OCT (DOCT) to diagnose ATN in human donor kidneys both prior to and following their transplantation

Summary

Introduction

Acute tubular necrosis (ATN), caused by a lack of oxygen to the kidney (ischemia of the kidneys), is one of the most common causes of kidney failure. It is a critical factor in determining the status of a kidney destined for transplantation. It has been shown that noninvasive imaging techniques [i.e., tandem scanning confocal microscopy (TSCM)] could be used to determine the degree of ATN by analyzing the supercial nephrons of living rabbit kidneys and that these observations correlate with post-transplant renal function.[1] This is not surprising in that the status of supercial proximal convoluted tubules is indicative of the status of proximal convoluted throughout the entire kidney cortex. A noninvasive microscopic procedure that has enough penetrating ability to image the human kidney parenchyma and determine the extent of ATN would provide invaluable clinical information regarding kidney function

Methods

Results

Conclusion