National Organ Retrieval Imaging System: results of the pilot study

Transpl Int. 2008 Nov;21(11):1036-44. doi: 10.1111/j.1432-2277.2008.00720.x.

Abstract

Efficient utilization of marginal liver grafts is dependant on the accurate assessment and relay of graft-related information to recipient units in an organ-sharing network. Currently, information is conveyed by the recovery team over the telephone and can sometimes be inconclusive or incomplete. We have developed a web-based instrument called the National Organ Retrieval Imaging System (NORIS) to improve this assessment process. The aim of this pilot study was to assess the feasibility of real-time data upload and the reliability of web-based remote assessment in identifying donor livers with significant macro-steatosis. Data from 153 donor livers uploaded to the website were analysed. Completeness of graft data uploads, accuracy of on-site and two separate remote assessments using a semi-objective graft score in identifying grafts with moderate or severe macro-vesicular steatosis were analysed. Uploads were complete in all recoveries. Liver grafts with moderate or severe macro-vesicular steatosis had a higher incidence of initial poor function (7/10 vs. 26/86, P = 0.029). Organ scores for steatotic grafts were significantly higher than nonsteatotic grafts in all three assessments (P < 0.001). Accuracy of the two remote assessors was similar to the actual on-site assessment. There was a substantial degree of inter-observer agreement between the assessments (kappa statistics = 0.658, 0.597, 0.698). Feasibility of real-time data upload and reliability of remote graft assessment have been confirmed.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Diagnostic Imaging
  • Donor Selection
  • Fatty Liver / diagnosis
  • Fatty Liver / pathology
  • Fatty Liver / surgery
  • Humans
  • Internet
  • Liver Transplantation / standards*
  • Observer Variation
  • Pilot Projects
  • Remote Consultation
  • Tissue and Organ Harvesting / methods*
  • Tissue and Organ Harvesting / standards
  • Tissue and Organ Procurement / standards
  • Treatment Outcome