Introduction: Liver biopsy at the time of procurement plays a crucial role in the acceptance of marginal grafts. Local pathologists and transplant surgery fellows are often not experienced with graft pathology evaluation. Telepathology via a smartphone application would allow liver biopsies to be evaluated in real time by expert hepatopathologists.

Methods: We retrospectively reviewed reports from local pathologists performed prior to transplant. A smartphone with microscope adapter was used to acquire and transmit digital images of these biopsy slides to two hepatopathologists for independent reads. All three pathology reads were compared to one another. Steatosis, fibrosis, and inflammation were among analyzed data points. Chi-square and Fisher tests were used to determine statistical significance.

Results: Twenty-one liver biopsies were included. Local pathologists found 91% of liver biopsies to have no to moderate macrosteatosis compared to 86% and 90% reported by hepatopathologists. Fibrosis was present in 5% of local pathology reads versus 0% and 14.3% in hepatopathology reads. No statistically significant difference was found between local pathology and telepathology reads for any data point collected (p < 0.05).

Conclusion: Telepathology via smartphone provides a reliable, simple, and inexpensive method to instantly review donor liver biopsies. The ability to transmit images from local hospitals to expert pathologists and senior surgeons in real time has the potential for a more accurate assessment of the organ quality and optimize liver allocation.

CITATION INFORMATION: Bath N., Wang X., Bledsoe J., Thijssen M., Ahearn A., Movahedi B., Bozorgzadeh A., Martins P. Real-Time Expert Evaluation of Liver Biopsy for Transplant: The Significance of Smartphone and Microscope Adapter in Telepathology Am J Transplant. 2017;17 (suppl 3).

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