Organ shortage: With this technology, we could be saving lives today

Organ transplantation is one of the greatest achievements of modern medicine, but in Germany it is significantly limited by three key challenges: the shortage of donor organs, long waiting times and an increasing shortage of skilled healthcare workers. Despite widespread support for organ donation among the population, outdated and time-consuming methods for assessing organ quality are delaying the entire process. “Traditional methods are often too slow and require highly specialized personnel, who are increasingly in short supply,” explains Dr. Roberto Banchi, an application expert at medical technology company VivaScope. However, new technological approaches, such as Ex Vivo confocal microscopy (FCM), offer hope of significantly improving this situation. “With technologies like the VivaScope 2500, we can speed up the transplantation process while significantly improving quality assurance,” Dr. Banchi emphasizes. He sees the digitalization of transplant pathology as a crucial step in combating the shortage of organs and optimizing patient care. The expert explains how these innovative technologies are already revolutionizing transplantation medicine and why their introduction into everyday clinical practice is urgently needed.

One in three people does not receive a donor kidney: The alarming reality of transplantation medicine

Kidney transplantation is the most common organ transplant in Germany, but the numbers are declining: In 2021, 1,992 kidneys were transplanted. In comparison, there were 2,272 kidney transplants in 2013.[1] Although everyone has two kidneys, donation is not easy – only healthy people can be considered, and not every kidney that is removed is actually transplanted. The hurdles are high: living donations are usually reserved for close relatives, and cadaveric donations require either the consent of the donor during their lifetime or the consent of the relatives. In addition, the compatibility between donor and recipient must be ensured. Here, groundbreaking technology could provide a decisive solution. “The VivaScope 2500 enables fast and precise assessment of donor organs directly after removal,” explains Dr. Banchi. This is confirmed by studies such as that by Villareal et al. (2020). “They show that the use of the VivaScope technique helps to avoid unnecessary re-biopsies and better ensures organ quality. This could help to increase the success rate of transplants in the future,” says the specialist. ‘Digital imaging and minimal sample preparation thus fundamentally reduce tissue loss and could thus optimize the entire transplant process – in a life-saving way,’ Dr. Banchi continues.

Germans wait up to 10 years for an organ donation

In Germany, patients often wait eight to ten years for an organ such as a kidney, while in countries like Spain or Austria, the waiting time is significantly shorter. According to Dr. Banchi, one reason for this is the time-consuming evaluation of donor organs. “Many hospitals do not have the necessary infrastructure for frozen section diagnostics available 24/7, which leads to delays and potentially to a smaller number of available organs,” explains the expert. Confocal fluorescence microscopy (FCM) could offer a promising solution: After transplantation, it is often necessary to take another biopsy of the transplanted organ in order to detect possible abnormalities such as rejection or infection at an early stage. Traditionally, this involves taking tissue, which then has to be laboriously prepared and examined histologically, a process that takes a lot of time. This is where VivaScope technology comes in, offering a faster and less invasive diagnostic method using fluorescence confocal microscopy (FCM). “In contrast to conventional histology, i.e. the assessment of tissue, sample preparation is so straightforward and can be done in a few minutes. The digital scans are immediately available online for review by pathologists, enabling faster diagnosis worldwide,” says Dr. Banchi. In a clinical study, the results for the assessment of liver biopsies are promising and could be particularly relevant for recipient biopsies after transplants. “The diagnostic accuracy of FCM is comparable to that of the frozen section method and provides reliable information about tumors and inflammatory infiltrates – faster and more connected,” emphasizes the application specialist. All in all, the VivaScope technology could therefore shorten waiting times for transplants – a significant step in view of the shortage of organs in Germany.

Old methods are time-, cost- and labour-intensive: digital saves lives

The shortage of medical professionals, especially in transplant pathology, is becoming an increasingly critical problem. Traditional methods such as frozen section analysis are time-consuming and costly and require highly specialized personnel, who are becoming increasingly scarce. Given the stagnating number of transplants, it is imperative that we introduce new technologies to facilitate these processes. Studies show that the use of advanced technologies such as the VivaScope 2500 has the potential to help close the staffing gap. This includes a study by Kinzler et al. (2023), which suggests that this Ex Vivo technology can make the transplantation process more efficient. “A major advantage is that the staining and scanning procedures can be performed by non-specialized staff after a short training period, which reduces the need for highly qualified specialists and relieves the burden on the healthcare system,” explains Dr. Banchi. In addition, VivaScope captures images of fresh tissue and avoids typical artifacts that occur in frozen tissue. This leads to a more reliable evaluation of potential transplants and preserves tissue integrity for subsequent examinations. This is particularly important when only limited tissue material is available. “If this technology becomes standard and supports current procedures, we can already perform many more successful transplants,” emphasizes Dr. Banchi. The option of immediate on-site or remote evaluation significantly reduces the need for time- and personnel-intensive transportation. This could not only reverse the stagnation in the number of transplants, but also strengthen the basis for an international, digital pathology network – a real opportunity to relieve the burden on the healthcare system and sustainably improve patient care.

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