First-in-human clinical trial for the assessment of kidney transplant quality using combined quantitative ultrasound and photoacoustic imaging

You have accessJournal of UrologyCME1 Apr 2023PD31-04 FIRST-IN-HUMAN CLINICAL TRIAL FOR THE ASSESSMENT OF KIDNEY TRANSPLANT QUALITY USING COMBINED QUANTITATIVE ULTRASOUND AND PHOTOACOUSTIC IMAGING Alexander Koven, Eno Hysi, Jihye Baek, Monica Farcas, Robert Stewart, Michael Ordon, Kenneth Pace, Adriana Krizova, Xiaolin He, Kevin Parker, Michael Kolios, and Darren Yuen Alexander KovenAlexander Koven More articles by this author , Eno HysiEno Hysi More articles by this author , Jihye BaekJihye Baek More articles by this author , Monica FarcasMonica Farcas More articles by this author , Robert StewartRobert Stewart More articles by this author , Michael OrdonMichael Ordon More articles by this author , Kenneth PaceKenneth Pace More articles by this author , Adriana KrizovaAdriana Krizova More articles by this author , Xiaolin HeXiaolin He More articles by this author , Kevin ParkerKevin Parker More articles by this author , Michael KoliosMichael Kolios More articles by this author , and Darren YuenDarren Yuen More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003324.04AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: While kidney transplantation has revolutionized the treatment of kidney failure, donor kidneys are in short supply. This leads physicians to accept kidneys from older and sicker donors. Many of these have pre-existing fibrosis and microvascular disease, which can cause damage and kidney function loss after transplantation. Unfortunately, current clinical tools for predicting graft outcomes fail to capture whole organ fibrosis and microvascular disease burden. Our group has developed quantitative ultrasound (US) and photoacoustic (PA) imaging to measure both collagen (the main component of fibrosis) and perfusion parameters. In this work, we investigate the use of US/PA imaging to noninvasively measure fibrosis and perfusion in human kidneys at the time of transplantation. METHODS: A VevoLAZR-X US/PA imaging system operating at 15 MHz was utilized for imaging. An algorithm using US frequency information (H-scan) was developed to estimate whole kidney fibrotic burden. Oxygen saturation (sO2) and total hemoglobin (HbT) were estimated using multispectral PA imaging. Donor kidneys were imaged in the operating room before transplantation during cold storage to measure H-scan fibrosis and then after vascular anastomosis to measure PA perfusion. For the primary outcome, H-scan fibrosis scores were correlated with fibrosis determined by HPS-stained biopsies. Clinical outcomes are also being collected for up to 5 years post-transplant. RESULTS: 46 patients have been imaged to date. These patients received either a living or deceased donor kidney transplant (LD n=23; DD n=23). As shown in Fig. 1a, the H-scan captures the increasing fibrotic burden with increasing %red pixels. Comparison with HPS-stained biopsies confirmed the accuracy of H-scan in assessing fibrosis (r=0.83, Fig. 1b). Post-perfusion, sO2 and HbT estimates were acquired (Fig. 1c), with the average sO2 increasing by approximately 20%. CONCLUSIONS: This is the first in-human study applying US/PA imaging to non-invasively and accurately measure kidney fibrovascular disease burden at the time of transplantation. Next steps will be to correlate imaging scores with clinical outcomes. Once complete, we expect our results will help optimize donor kidney selection and matching to the most appropriate recipients. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e901 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Alexander Koven More articles by this author Eno Hysi More articles by this author Jihye Baek More articles by this author Monica Farcas More articles by this author Robert Stewart More articles by this author Michael Ordon More articles by this author Kenneth Pace More articles by this author Adriana Krizova More articles by this author Xiaolin He More articles by this author Kevin Parker More articles by this author Michael Kolios More articles by this author Darren Yuen More articles by this author Expand All Advertisement PDF downloadLoading ...