Precision transplant pathology

Abstract

Purpose of review Transplant pathology contributes substantially to personalized treatment of organ allograft recipients. Rapidly advancing next-generation human leukocyte antigen (HLA) sequencing and pathology are enhancing the abilities to improve donor/recipient matching and allograft monitoring. Recent findings The present review summarizes the workflow of a prototypical patient through a pathology practice, highlighting histocompatibility assessment and pathologic review of tissues as areas that are evolving to incorporate next-generation technologies while emphasizing critical needs of the field. Summary Successful organ transplantation starts with the most precise pratical donor–recipient histocompatibility matching. Next-generation sequencing provides the highest resolution donor–recipient matching and enables eplet mismatch scores and more precise monitoring of donor-specific antibodies (DSAs) that may arise after transplant. Multiplex labeling combined with hand-crafted machine learning is transforming traditional histopathology. The combination of traditional blood/body fluid laboratory tests, eplet and DSA analysis, traditional and next-generation histopathology, and -omics-based platforms enables risk stratification and identification of early subclinical molecular-based changes that precede a decline in allograft function. Needs include software integration of data derived from diverse platforms that can render the most accurate assessment of allograft health and needs for immunosuppression adjustments.

Autoantibodies to LG3 are associated with poor long‐term survival after liver retransplantation

“…25 Precision transplantation diagnostics combine serological biomarkers, pathological analysis, and allograft function tests to provide evidence for optimal patient management. 39 Due to the long study period, the detailed causes of regraft loss and histopathological analysis were incomplete. Despite its novelty, this study will need validation in a larger cohort of patients with more comprehensive longitudinal post-transplantation data, including pathological examinations.…”

“…Precision transplantation diagnostics combine serological biomarkers, pathological analysis, and allograft function tests to provide evidence for optimal patient management 39 . Due to the long study period, the detailed causes of regraft loss and histopathological analysis were incomplete.…”

The Molecular Microscope (MMDXR) interpretation of thoracic and abdominal allograft biopsies: Putting things in perspective for the clinician

“…popularity and may render MMDx technology obsolete in the years to come. [20][21][22] The advent of three-dimensional intact-tissue sequencing of single-cell transcriptional states is particularly noteworthy. 23…”

“…Recent developments in histopathology, such as multiplex labeling, automated image analysis, and machine learning, are making it all the more important for gene expression data be analyzed in a way that surpasses the “blind grind and find” approach utilized by MMDx. Demand for platforms that merge spatial context with targeted mRNA and/or protein expression are growing in popularity and may render MMDx technology obsolete in the years to come 20‐22 . The advent of three‐dimensional intact‐tissue sequencing of single‐cell transcriptional states is particularly noteworthy 23 …”

Care of Maintenance Hemodialysis Patients through Intelligent Algorithm-Based Low-Dose Digital Subtraction Angiography

“…Consequently, CNN can be applied to eliminate artifacts in DSA images, so as to reduce the radiation doses. Deep learning-based feature extraction extracts DSA vascular subtraction from a single frame to eliminate the dependence on the background frame and reduce the exposure time and radiation dose [15].…”