Today in the United States, 114,000 people are on the National Transplant Waiting list. Over the last two and a half decades, these numbers have grown by nearly 80% due in large part to increased educational awareness and a higher demand for life-saving surgery. Liver and kidney patients now make up the vast majority of the list’s transplant hopefuls, with approximately 108,000 people awaiting these organs.
At the same time, organ transplants increased to nearly 35,000 surgeries performed in 2017, which is a record for the fifth year in a row. One of the main channels that Organ Transplant Organizations (OPOs) are utilizing to help elevate these successful matches is an expansion of the potential donor pool to include those who may exhibit less than ideal medical criteria.
Since both transplant patients and surgeons alike demand high quality standards before accepting kidneys and livers in order to minimize rejection rates, this expansion needs to be balanced with increasingly effective histopathology interpretations. Digital pathology is leading the way in this endeavor through more in-depth, collaborative, and far-reaching processes that assist in improving organ allocation and increasing the number of viable donors.
Increasing OPO and Patient Confidence
A recent telepathology study out of the Netherlands revealed the high sensitivity rates that digital interpretations bring to liver graft biopsies. These rates were over 90% for injuries and hematomas, and an astounding 100% for tumors. Rates for renal biopsies revealed an even higher validity, with over 95% hematoma and 100% tumor and injury sensitivities.
These highly accurate diagnostic rates are helping to elevate patient confidence in OPO services. This is further helped along by digital pathology’s ability to offer fast access to highly trained specialists. Because of this opportune availability, organizations no longer have to turn to less reliable forms of transplant interpretations, but instead have wider access to ‘gold standard’ diagnoses 24 hours a day, 7 days a week.
These benefits are further optimized by digital platforms that keep information and workflow processes ideally organized. This allows for more streamlined case distribution, diagnosis, and revisions, as well as highly proficient double reporting. In fact, a recent transplant pathology study revealed a probable time savings of 15% by using telemedicine versus traditional modes of analysis. This increased efficiency is coupled with improved reproducibility rates and more targeted quality assurance checks of data that help ensure the best possible kidney and liver transplant outcomes.
Unlocking Innovative Collaborations and Advancing Holistic Diagnoses
Digital pathology platforms also allow telepathologists to access data relevant to their diagnosis from a wide array of resources, including industry professionals, colleagues, and educational institutions. This ability to quickly share and exchange data helps boost diagnostic objectivity by broadening understanding of graft morphology. In addition, engineers and computer scientists have developed in-depth algorithms and built-in AI imaging analysis to assist in pulling together patterns of pathology, which aids in correctly identifying and evaluating a graft’s biomarkers in order to ensure optimal diagnostic success rates.
The availability of digital whole slide imaging (WSI) has also helped improve pathology graft interpretations through enhanced viewing capabilities. Advanced pixel data technology allows for high resolution images that have been shown to increase image clarity and depth of focus, helping to make WSI a top choice for use in transplant interpretations. Images can also be compared side-by-side within a digital portal in order to ensure the most objective and quantifiable biopsy results possible.
Perhaps the most exciting and far-reaching aspect of these advances in digital software are the exchanges of data now possible with the exploding fields of genomics, proteomics, and metabolomics. Specifically, digital technology is helping advance the use of multiplex staining, also known as ‘multiplexing’. This technique allows for the identification of three or more protein biomarkers at the same time within one sample, which can then be linked to relevant tissue biomarkers embedded in the patient’s liver or kidney graft.
These previously expensive and somewhat tedious multiplex stain captures were often too cost-prohibitive and time-consuming to be utilized in their ideal quantities, despite their inherent value in providing a much more holistic diagnosis to OPOs. They were also quite vulnerable to photobleaching from the fluorescence microscopes, which limited image complexity.
With the innovative digitized process used by telepathologists, the stains can be converted to whole slide images and easily analyzed and compared to those housed within the digital storage platform, without fear of degradation. This allows telepathologists access to a highly advantageous range of injury, repair, and tissue data in order to optimize their liver and kidney graft interpretations.
Research has revealed that telepathology increases accessibility of care by aiding OPOs in reaching a wider range of patients, creating a win-win situation for all parties involved. This is due to the inherent nature of the practice, which allows even the most remotely situated medical practices to have fast access to biopsy results by board certified kidney and liver specialists. This extended reach is helping OPOs grow their patient base while still maintaining high quality standards.
Since the demand for well-trained pathologists is expected to grow by 16% in the in the coming decade due to reduced workforce numbers, digital pathology’s fast, efficient, and highly accurate processes are now being recognized as a valuable tool to help to bridge the gap between reduced staff levels and higher OPO workloads. This efficiency is part of the reason why a 5-year financial projection revealed a cost savings of between $3 and $12 million for medical facilities who integrate digital pathology technology into their existing practices.
Our advanced PACS technology, industry-leading customer service, and valuable partnership with Washington University School of Medicine’s board-certified pathologists all combine to ensure that your OPO receives optimal organ interpretations that help save lives. With specialists available 24/7/365, we provide unsurpassed access to propel your success forward.