The large liver transplant waitlists and increasing of marginal donor organs call for a rapid, non-destructive method of evaluating organ quality for transplantation. We demonstrate a diffuse optical non-destructive organ risk (DONOR) indexing method for identifying significant liver pathology, in particular unacceptable fibrosis and necrosis. Measurements were acquired from 27 human livers not meeting the clinical criteria for transplantation (OUHSC IRB #8155). A portable lab-on-a-crate diffuse optical spectroscopy (DOS) device with a hands-free probe of 3mm source-detector separation was used for measurements on liver surface and cross-section. The DOS measurements were obtained from a total of five sites, including the right anterior, right posterior, and left anterior liver surfaces and the right and left cut sections, and corresponding tissue sections were obtained for formalin-fixed paraffin embedded (FFPE) H&E controls of 8 types of liver pathology. Due to the difficulty of obtaining a control liver, a clinically inconspicuous and histologically unremarkable liver number 24 was used as the baseline for DONOR index processing. For the measurements at the cross-sectional parenchyma of the right lobe alone, a single threshold of the DONOR index at 1.5 identified all six livers with fibrosis stage ≥2 and one liver with necrosis=5, in the presence of mixed pathologies. A prime pattern of altering the DOS profile by the fibrosis alone is identified. The surface measurements differ from the parenchyma measurements at various levels, due to the shielding effect of the thin collagen-rich capsule. DONOR indexing of liver pathology is promising, but requiring unsheilding the capsular effect.
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