Inulin Clearance During Ex vivo Normothermic Machine Perfusion as a Marker of Renal Function.

Normothermic machine perfusion (NMP) offers a unique opportunity to objectively assess donor organ quality. This study describes the evaluation of inulin clearance as a potential marker for the ex vivo function of porcine kidneys during NMP. The function assessment was performed in both kidneys from slaughterhouse pigs (n = 20) and kidneys from pigs in a laboratory setting (n = 28). The kidneys were exposed to different warm ischemia times (WIT). After a period of static cold storage, the kidneys underwent a 4-hour NMP with autologous whole blood. Inulin clearance, hemodynamic parameters, and urine output were measured. Based on the inulin excretion behavior laboratory pig kidneys were assigned to three classes (functional, limited functional, and nonfunctional), slaughterhouse pig kidneys to two classes (limited functional and nonfunctional), respectively. Contrary to the marginal kidneys of the slaughterhouse pigs, the functional variation of kidneys of the laboratory pigs was associated with the WIT. A correlation between functional kidneys and a WIT less than 25 min was shown. Because none of the slaughterhouse pig kidneys could be assigned to the functional class, only the laboratory pig kidneys were used for examinations with functional markers. Renal blood flow and urine output during NMP correlated significantly ( p < 0.01) with ex vivo kidney function. This study demonstrated that inulin is a marker of high quality for the evaluation of suggested kidney function after NMP with whole blood. Furthermore, surrogate markers measured during NMP can be used to describe and predict the physiologic behavior of kidneys before transplantation.

Comparison of different spectral cameras for image-guided organ transplantation.

SIGNIFICANCE: Hyperspectral and multispectral imaging (HMSI) in medical applications provides information about the physiology, morphology, and composition of tissues and organs. The use of these technologies enables the evaluation of biological objects and can potentially be applied as an objective assessment tool for medical professionals. AIM: Our study investigates HMSI systems for their usability in medical applications. APPROACH: Four HMSI systems (one hyperspectral pushbroom camera and three multispectral snapshot cameras) were examined and a spectrometer was used as a reference system, which was initially validated with a standardized color chart. The spectral accuracy of the cameras reproducing chemical properties of different biological objects (porcine blood, physiological porcine tissue, and pathological porcine tissue) was analyzed using the Pearson correlation coefficient. RESULTS: All the HMSI cameras examined were able to provide the characteristic spectral properties of blood and tissues. A pushbroom camera and two snapshot systems achieve Pearson coefficients of at least 0.97 compared to the ground truth, indicating a very high positive correlation. Only one snapshot camera performs moderately to high positive correlation (0.59 to 0.85). CONCLUSION: The knowledge of the suitability of HMSI cameras for accurate measurement of chemical properties of biological objects offers a good opportunity for the selection of the optimal imaging tool for specific medical applications, such as organ transplantation.

Workflow and hardware for intraoperative hyperspectral data acquisition in neurosurgery.

To prevent further brain tumour growth, malignant tissue should be removed as completely as possible in neurosurgical operations. Therefore, differentiation between tumour and brain tissue as well as detecting functional areas is very important. Hyperspectral imaging (HSI) can be used to get spatial information about brain tissue types and characteristics in a quasi-continuous reflection spectrum. In this paper, workflow and some aspects of an adapted hardware system for intraoperative hyperspectral data acquisition in neurosurgery are discussed. By comparing an intraoperative with a laboratory setup, the influences of the surgical microscope are made visible through the differences in illumination and a pixel- and wavelength-specific signal-to-noise ratio (SNR) calculation. Due to the significant differences in shape and wavelength-dependent intensity of light sources, it can be shown which kind of illumination is most suitable for the setups. Spectra between 550 and 1,000 nm are characterized of at least 40 dB SNR in laboratory and 25 dB in intraoperative setup in an area of the image relevant for evaluation. A first validation of the intraoperative hyperspectral imaging hardware setup shows that all system parts and intraoperatively recorded data can be evaluated. Exemplarily, a classification map was generated that allows visualization of measured properties of raw data. The results reveal that it is possible and beneficial to use HSI for wavelength-related intraoperative data acquisition in neurosurgery. There are still technical facts to optimize for raw data detection prior to adapting image processing algorithms to specify tissue quality and function.

Contact Pressure and Flexibility of Multipin Dry EEG Electrodes.

In state-of-the-art electroencephalography (EEG) Silver/Silver-Chloride electrodes are applied together with electrolyte gels or pastes. Their application requires extensive preparation, trained medical staff and limits measurement time and mobility. We recently proposed a novel multichannel cap system for dry EEG electrodes for mobile and out-of-the-lab EEG acquisition. During the tests with these novel polymer-based multipin dry electrodes, we observed that the quality of the recording depends on the applied normal force and resulting contact pressure. Consequently, in this paper we systematically investigate the influence of electrode-skin contact pressure and electrode substrate flexibility on interfacial impedance and perceived wearing comfort in a study on 12 volunteers. The normal force applied to the electrode was varied between the minimum required force to achieve impedances and a maximum of 4 N, using a new force measurement applicator. We found that for a polymer shore hardness A98, with increasing normal force, the impedance decreases from and to and at frontal hairless and temporal hairy positions, respectively. Similar results were obtained for shore A90, A80, and A70. The best compromise of low and stable impedances as well as a good wearing comfort was determined for applied normal forces between 2 and 3 N using electrodes with shore A98 or A90. Our results provide the basis for improved EEG cap designs with optimal wearing comfort and recording quality for dry multipin electrodes, which will enable new fields of application for EEG.