Efficient Donor Tissue Assessment through Integrated WSI and LIS for a Regional Organ Donor Bank: An Untapped Application of Virtual Microscopy
Shriram Jakate, David Cimbaluk, Michael Harmon, Martin Jendrisak. Rush University Medical Center, Chicago, IL; Gift of Hope, Itasca, IL
Background: Organ harvesting for transplantation is complex and involves diverse locations, donor selection, organ procurement and preservation, tissue matching and donor tissue assessment for transplant worthiness. While most other steps are performed by trained donor bank staff, urgent tissue assessment involves frozen sectioning and evaluation by a pathologist. This step could be rate limiting due to delay in tissue transport and processing, unavailability of expertise and lack of time for consultation. Virtual microscopy, through integrated whole slide imaging (WSI) and laboratory information system (LIS), addresses these issues and extends readily available electronic data to all the organ receiving centers in the network.
Design: From June 2011 through August 2012, 142 cases of bilateral renal donor tissue and were subjected to around-the-clock frozen sections and WSI and uploaded to an integrated LIS in a regional organ donor bank's centralized laboratory serving parts of two states. All cases were immediately and remotely reviewed and reported via virtual microscopy by 1 of 6 University medical center pathologists on-call, well-versed with virtual microscopy. The LIS had integrated WSI, donor clinical data, fillable kidney biopsy reporting templates and in selected cases, gross images of the organs. After the organ was either utilized or discarded, the glass slides were subsequently reviewed (within one week) by an expert renal pathologist for validation of WSI assessment.
Results: There was total concordance between WSI and subsequent expert glass slide review with no impact on organ utilization (100% agreement). The reasons for such concordance included ready availability of clinical data, systematic and detailed enforced entries into templates creating consistent and reproducible reports, high quality of scanning and comfort-level between pathologists for virtual microscopy. No case was rejected due to inability to read WSI. All state-wide centers utilizing the donor organ had the ability to remotely view the entire donor data including WSI and seek instant additional consultation if needed.
Conclusions: Integrated WSI, LIS and virtual microscopy is highly effective and efficient in an organ donor network setting. This untapped application of virtual microscopy addresses both the geographic and time constraints inherent in organ donation process. Furthermore, at the points of organ utilization, the entire clinical, laboratory and tissue electronic data is available for instant reappraisal.
Wednesday, March 6, 2013 1:00 PM
Poster Session VI # 261, Wednesday Afternoon