Advantages of Using a Web-based Digital Platform for Kidney Preimplantation Biopsies.

Digital pathology innovation technology preimplantation biopsy

Journal

Journal of pathology informatics
ISSN: 2229-5089
Titre abrégé: J Pathol Inform
Pays: United States
ID NLM: 101528849

Informations de publication

Date de publication:
2021
Historique:
received: 06 04 2021
revised: 02 06 2021
accepted: 20 06 2021
entrez: 9 12 2021
pubmed: 10 12 2021
medline: 10 12 2021
Statut: epublish

Résumé

In the setting of kidney transplantation, histopathology of kidney biopsies is a key element in the organ assessment and allocation. Despite the broad diffusion of the Remuzzi-Karpinski score on preimplantation kidney biopsies, scientific evidence of its correlation to the transplantation outcome is controversial. The main issues affecting the prognostic value of histopathology are the referral to general on-call pathologists and the semiquantitative feature of the score, which can raise issues of interpretation. Digital pathology has shown very reliable and effective in the oncological diagnosis and treatment; however, the spread of such technologies is lagging behind in the field of transplantation. The aim of our study was to create a digital online platform where whole-slide images (WSI) of preimplantation kidney biopsies could be uploaded and stored. We included 210 kidney biopsies collected between January 2015 and December 2019 from the joint collaboration of the transplantation centers of Padua and Verona. The selected slides, stained with hematoxylin and eosin, were digitized and uploaded on a shared web platform. For each case, the on-call pathologists' Remuzzi grades were obtained from the original report, together with the clinical data and the posttransplantation follow-up. The storage of WSI of preimplantation kidney biopsies would have several clinical, scientific, and educational advantages. The clinical utility relies on the possibility to consult online expert pathologists and real-time quality checks of diagnosis. From the perspective of follow-up, the archived digitized biopsies can offer a useful comparison to posttransplantation biopsies. In addition, the digital online platform is a precious tool for multidisciplinary meetings aimed both at the clinical discussion and at the design of research projects. Furthermore, this archive of readily available WSI is an important educational resource for the training of professionals. Finally, the web platform lays the foundation for the introduction of artificial intelligence in the field of transplantation that would help create new diagnostic algorithms and tools with the final aim of increasing the precision of organ assessment and its predictive value for transplant outcome.

Sections du résumé

BACKGROUND BACKGROUND
In the setting of kidney transplantation, histopathology of kidney biopsies is a key element in the organ assessment and allocation. Despite the broad diffusion of the Remuzzi-Karpinski score on preimplantation kidney biopsies, scientific evidence of its correlation to the transplantation outcome is controversial. The main issues affecting the prognostic value of histopathology are the referral to general on-call pathologists and the semiquantitative feature of the score, which can raise issues of interpretation. Digital pathology has shown very reliable and effective in the oncological diagnosis and treatment; however, the spread of such technologies is lagging behind in the field of transplantation. The aim of our study was to create a digital online platform where whole-slide images (WSI) of preimplantation kidney biopsies could be uploaded and stored.
METHODS METHODS
We included 210 kidney biopsies collected between January 2015 and December 2019 from the joint collaboration of the transplantation centers of Padua and Verona. The selected slides, stained with hematoxylin and eosin, were digitized and uploaded on a shared web platform. For each case, the on-call pathologists' Remuzzi grades were obtained from the original report, together with the clinical data and the posttransplantation follow-up.
RESULTS RESULTS
The storage of WSI of preimplantation kidney biopsies would have several clinical, scientific, and educational advantages. The clinical utility relies on the possibility to consult online expert pathologists and real-time quality checks of diagnosis. From the perspective of follow-up, the archived digitized biopsies can offer a useful comparison to posttransplantation biopsies. In addition, the digital online platform is a precious tool for multidisciplinary meetings aimed both at the clinical discussion and at the design of research projects. Furthermore, this archive of readily available WSI is an important educational resource for the training of professionals.
CONCLUSIONS CONCLUSIONS
Finally, the web platform lays the foundation for the introduction of artificial intelligence in the field of transplantation that would help create new diagnostic algorithms and tools with the final aim of increasing the precision of organ assessment and its predictive value for transplant outcome.

Identifiants

pubmed: 34881096
doi: 10.4103/jpi.jpi_23_21
pii: S2153-3539(22)00163-8
pmc: PMC8609286
doi:

Types de publication

Journal Article

Langues

eng

Pagination

41

Informations de copyright

Copyright: © 2021 Journal of Pathology Informatics.

Déclaration de conflit d'intérêts

There are no conflicts of interest.

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Auteurs

Flavia Neri (F)

Department of Surgical, Oncological and Gastroenterological Sciences, Unit of Kidney and Pancreas Transplantation, University of Padua, Padua, Italy.

Albino Eccher (A)

Department of Pathology and Diagnostic, University and Hospital Trust of Verona, Verona, Italy.

Paolo Rigotti (P)

Department of Surgical, Oncological and Gastroenterological Sciences, Unit of Kidney and Pancreas Transplantation, University of Padua, Padua, Italy.

Ilaria Girolami (I)

Division of Pathology, Central Hospital Bolzano, Bolzano, Italy.

Gianluigi Zaza (G)

Department of General Medicine, Renal Unit, University and Hospital Trust of Verona, Verona, Italy.

Giovanni Gambaro (G)

Department of General Medicine, Renal Unit, University and Hospital Trust of Verona, Verona, Italy.

MariaGaia Mastrosimini (M)

Department of Pathology and Diagnostic, University and Hospital Trust of Verona, Verona, Italy.

Giulia Bencini (G)

Department of Surgical, Oncological and Gastroenterological Sciences, Unit of Kidney and Pancreas Transplantation, University of Padua, Padua, Italy.

Caterina Di Bella (CD)

Department of Surgical, Oncological and Gastroenterological Sciences, Unit of Kidney and Pancreas Transplantation, University of Padua, Padua, Italy.

Claudia Mescoli (C)

Department of Medicine, Surgical Pathology and Cytopathology Unit, University of Padua, Padua, Italy.

Luigino Boschiero (L)

Department of Surgical Sciences, Kidney Transplant Center, Hospital Trust of Verona, Verona, Italy.

Stefano Marletta (S)

Department of Pathology and Diagnostic, University and Hospital Trust of Verona, Verona, Italy.

Paolo Angelo Dei Tos (PAD)

Department of Medicine, Surgical Pathology and Cytopathology Unit, University of Padua, Padua, Italy.

Lucrezia Furian (L)

Department of Surgical, Oncological and Gastroenterological Sciences, Unit of Kidney and Pancreas Transplantation, University of Padua, Padua, Italy.

Classifications MeSH