Table 2.
Summary of papers dealing with posttransplantation liver graft biopsy
| Author, year | Type of digital pathology | Number of patients/biopsies | Type of biopsy | Intervention | Controls or comparisons | Outcomes/Aim of study | Results |
|---|---|---|---|---|---|---|---|
| Ito etal., 1994 | Static | 22 | Graft liver and kidney biopsy | Telepathology diagnosis | Direct LM diagnosis | Descriptive results | Agreement in 10/12 kidney biopsies and in 9/10 liver biopsies |
| Ben-Hari etal., 1995 | LM plus DIA | 55 (92 biopsies) | Graft liver biopsy | DIA assessment of eosinophil count, cell density and cross-sectional area in portal tract | None | Descriptive correlation of parameters with different degrees of rejection | Positive correlation of all parameters with severity of rejection |
| Minervini etal., 2001 | Static | 102, among which 9 liver graft and 9 kidney graft biopsies | Various case types: Second opinion consultation, transplantation pathology, general surgical pathology | Consultant telepathology review | Referring pathologist original diagnosis | Agreement rates, descriptive | 86% agreement and 14% (only 3% major) disagreement between referring and consultant pathologist |
| El-Refaie etal., 2005 | LM plus DIA | 267 (343 biopsies) | Graft liver biopsy | DIA software quantification of mast cells and IHC staining | None | Correlation of mast cell count and IHC staining with different degrees of rejection | Strong correlation of mast cells with acute rejection and of IHC staining for c-Kit with severity of rejection |
| Calvaruso etal., 2008 | LM plus DIA | 115 (225 biopsies) | Graft liver biopsy | DIA software quantification of collagen proportionate area | None | Descriptive correlation between DIA measurements, Ishak score, and portal hypertension | Collagen proportionate area assessed by DIA correlated with Ishak stage scores and portal hypertension |
| Guzman etal., 2010 | LM plus DIA | 19 (33 biopsies) | Graft liver biopsy | Anisonucleosis and oxidative damage scored by DIA | None | Descriptive correlation of anisonucleosis with different clinical parameters | Higher anisonucleosis in individuals with diabetes and with high expression of oxidative damage marker |
| Manousou etal., 2011 | LM plus DIA | 135 | Graft liver biopsy | Computer-assisted DIA quantification of collagen proportionate area | None | Descriptive correlation between DIA measurements, Ishak score, and decompensation | Collagen proportionate area assessed by DIA correlated with Ishak stage scores and decompensation |
| Calvaruso etal., 2012 | LM plus DIA | 65 | Graft liver biopsy | Computer-assisted DIA quantification of collagen proportionate area | None | Descriptive correlation between DIA measurements, portal hypertension and graft outcome | Collagen proportionate area assessed by DIA correlated with portal hypertension and decompensation |
| Manousou etal., 2013 | LM plus DIA | 155 (587 biopsies) | Graft liver biopsy | Computer-assisted DIA quantification of collagen proportionate area and rate of increase | None | Descriptive correlation of DIA measurements and Ishak score with portal hypertension and graft outcome | Progression rate of fibrosis is a better predictor of clinical outcome than progression by Ishak stage |
| Sclair etal., 2016 | LM plus DIA | 60 | Graft liver biopsy | DIA software assessment of ductular reaction in HCV recurrent recipients with cirrhosis | DIA software assessment of ductular reaction in stable recurrent HCV recipients with no cirrhosis or fibrosing hepatitis | Descriptive difference among the groups | Significantly higher ductular reaction in recipients with cirrhosis |
| Neil etal., 2017 | WSI | 40 | TMAs of graft and native liver, kidney, heart | Pathologists scoring C4d with WSI | Pathologists scoring C4d with LM | Descriptive surveys of pathologists and comparison of staining methods | Strong and diffuse portal vein and capillary C4d staining, determined by both local and central pathologists, distinguished acute antibody-mediated rejection from native livers |
| Saco etal., 2017 | WSI | 64 | Graft liver biopsy | Pathologist with WSI | Pathologist with LM | Intra- and inter-observer agreement | Almost perfect intraobserver concordance between modalities; high interobserver concordance for WSI (κ=0.80) |
DIA: Digital image analysis, HCV: Hepatitis C virus, IHC: Immunohistochemistry, LM: Light microscopy, TMAs: Tissue microarrays, WSI: Whole-slide imaging