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Title: Multi-photon microscopy for the evaluation of interstitial fibrosis in extended criteria donor kidneys: A proof-of-concept study
Authors: So, Wei Zheng
Teo, Rachel Zui Chih
Ooi, Li Yin
Goh, Benjamin Yen Seow 
Lu, Jirong
Vathsala, Anantharaman 
Thamboo, Thomas Paulraj 
Tiong, Ho Yee 
Keywords: donor
extended criteria donors
interstitial fibrosis
kidney transplantation
multi-photon microscopy
Issue Date: 29-May-2022
Publisher: WILEY
Citation: So, Wei Zheng, Teo, Rachel Zui Chih, Ooi, Li Yin, Goh, Benjamin Yen Seow, Lu, Jirong, Vathsala, Anantharaman, Thamboo, Thomas Paulraj, Tiong, Ho Yee (2022-05-29). Multi-photon microscopy for the evaluation of interstitial fibrosis in extended criteria donor kidneys: A proof-of-concept study. CLINICAL TRANSPLANTATION. ScholarBank@NUS Repository.
Abstract: Introduction: To evaluate the initial use of label-free second harmonic generation (SHG) imaging with two-photon excitation (2PE) auto-fluorescence in multiphoton microscopy (MPM) for the quantification of collagen/fibrosis on preimplantation biopsies of extended criteria donors (ECD). Materials and methods: Twenty preimplantation core biopsies were extracted from 10 donor kidney samples, of which originated from seven donors. Kidney Donor Profile Index (KDPI) and Remuzzi scores of biopsies were calculated. Collagen parameters measured included quantification by the Collagen Area Ratio in Total Tissue (CART) and qualitative measurements by Collagen Reticulation Index (CRI). Results: Biopsies classified with > 85% KDPI scores had significantly higher CART (p =.011) and lower CRI values (p =.025) than biopsies with ≤ 85% KDPI scores. Increase in CRI values correlated significantly with rise in recipient creatinine levels 1-year post-transplant (p =.027; 95% CI: 4.635-66.797). Conclusion: MPM is an evolving technology that enables the quantification of the amount (CART) and quality (CRI) of collagen deposition in unstained preimplantation biopsies of donor kidneys stratified by KDPI scores. This initial evaluation found significant differences in both parameters between donor kidneys with more or less than 85% KDPI.
ISSN: 0902-0063
DOI: 10.1111/ctr.14717
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