Novel Imaging Technologies for Accurate Assessment of Cardiac Allograft Performance

Abstract

Purpose of the Review The current lack of objective and quantitative assessment techniques to determine cardiac graft relative viability results in risk-averse decision-making, which negatively impact the utilization of cardiac grafts. The purpose of this review is to highlight the current deficiencies in cardiac allograft assessment before focusing on novel cardiac assessment techniques that exploit conventional and emerging imaging modalities, including ultrasound, magnetic resonance, and spectroscopy. Recent Findings Extensive work is ongoing by the scientific community to identify improved objective metrics and tools for cardiac graft assessment, with the goal to safely increasing the number and proportion of hearts accepted for transplantation. Summary This review briefly discusses the in situ and ex vivo tools currently available for clinical organ assessment, before focusing on the individual capabilities of ultrasound, magnetic resonance, and spectroscopy to provide insightful, non-invasive information regarding cardiac graft functional and metabolic status that may be used to predict outcome after transplantation.

Real-time monitoring of mitochondrial oxygenation during machine perfusion using resonance Raman spectroscopy predicts organ function

“…We successfully developed a novel approach that provides a reporter free highly specific readout of functional oxidation state of mitochondrial cytochromes during machine perfusion in real-time. Better understanding of mitochondrial function using 3RMR may help in better optimization of the strategies for reperfusion, while minimizing injury and maximizing functional recovery before transplant 38 .…”

Real-time monitoring of mitochondrial oxygenation during machine perfusion using resonance Raman spectroscopy predicts organ function

“…We successfully developed a novel approach that provides a reporter free highly specific readout of functional oxidation state of mitochondrial cytochromes during machine perfusion in real-time. Better understanding of mitochondrial injury may not only help in better optimization of storage and perfusion conditions, but also assess the extent of injury and function of organs before transplant 42 . Thus, optimal assessment may allow the use of organs from donors deceased due to cardiac death (DCD) and other extended criteria donor (ECD) organs.…”