Organ transplantation is one of the most important and effective solutions to save end-stage patients, who have one or more critical organ failures. However, the inadequate organs for transplantation to meet the demands has been the major issue. Even worse, the lack of accurate non-invasive assessment methods wastes 20% of donor organs every year. Currently, the most frequently used organ assessment methods are visual inspections and biopsy. Yet both methods are subjective: the assessment accuracy depends on the evaluator's experience. Moreover, repeating biopsies will potentially damage the organs. To reduce the waste of donor organs, online non-invasive and quantitative organ assessment methods are in great needs.
Organ viability assessment is a challenging issue due to four reasons: 1) there are no universally accepted guidelines or procedures for surgeons to quantitatively assess the organ viability; 2) there is no easy-deployed and non-invasive biological in situ data to correlate with organ viability; 3) the organs viability is difficult to model because of heterogeneity among organs; 4) both visual inspection and biopsy can be applied only at present time, and how to forecast the viability of similar-but-non-identical organs at a future time is still in shadow.
Motivated by the challenges, the overall objective of this dissertation is to develop online non-invasive and quantitative assessment methods to predict and forecast the organ viability. As a result, four data-driven modeling research tasks are investigated to achieve the overall objective:
1) Quantitative and qualitative models are used to jointly predict the number of dead cells and the liver viability based on features extracted from biopsy images. This method can quantitatively assess the organ viability, which could be used to validate the biopsy results from pathologists to increase the evaluation accuracy.
2) A multitask learning logistic regression model is applied to assess liver viability by using principal component analysis to extract infrared image features to quantify the correlation between liver viability and spatial infrared imaging data. This non-invasive online assessment method can evaluate the organ viability without physical contact to reduce the risk of damaging the organs.
3) A spatial-temporal smooth variable selection method is conducted to improve the liver viability prediction accuracy by considering both spatial and temporal effects from the infrared images without feature engineering. In addition, it provides medical interpretation based on variable selection to highlight the most significant regions on the liver resulting in viability loss.
4) A multitask general path model is implemented to forecast the heterogeneous kidney viability based on limited historical data by learning the viability loss paths of each kidney during preservation. The generality of this method is validated by tissue deformation forecasting in needle biopsy process to potentially improve the biopsy accuracy.
In summary, the proposed data-driven methods can predict and forecast the organ viability without damaging the organ. As a result, the increased utilization rate of donor organs will benefit more end-stage patients by dramatically extending their life spans. / Doctor of Philosophy / Organ transplantation is the ultimate solution to save end-stage patients with one or more organ failures. However, the inadequate organs for transplantation to meet the demands has been the major issue. Even worse, the lack of accurate and non-invasive viability assessment methods wastes 20% of donor organs every year. Currently, the most frequently used organ assessment methods are visual inspections and biopsy. Yet both methods are subjective: the assessment accuracy depends on the personal experience of evaluator. Moreover, repeating biopsies will potentially damage the organs. As a result, online non-invasive and quantitative organ assessment methods are in great needs. It is extremely important because such methods will increase the organ utilization rate by saving more discarded organs with transplantation potential.
The overall objective of this dissertation is to advance the knowledge on modeling organ viability by developing online non-invasive and quantitative methods to predict and forecast the viability of heterogeneous organs in transplantation. After an introduction in Chapter 1, four research tasks are investigated. In Chapter 2, quantitative and qualitative models jointly predicting porcine liver viability are proposed based on features from biopsy images to validate the biopsy results. In Chapter 3, a multi-task learning logistic regression model is proposed to assess the cross-liver viability by correlating liver viability with spatial infrared data validated by porcine livers. In Chapter 4, a spatial-temporal smooth variable selection is proposed to predict liver viability by considering both spatial and temporal correlations in modeling without feature engineering, which is also validated by porcine livers. In addition, the variable selection results provide medical interpretations by capturing the significant regions on the liver in predicting viability. In Chapter 5, a multitask general path model is proposed to forecast kidney viability validated by porcine kidney. This forecasting method is generalized to apply to needle biopsy tissue deformation case study with the objective to improve the needle insertion accuracy. Finally, I summarize the research contribution and discuss future research directions in Chapter 6. The proposed data-driven methods can predict and forecast organ viability without damaging the organ. As a result, the increased utilization rate of donor organs will benefit more patients by dramatically extending their life spans and bringing them back to normal daily activities.
| Identifer | oai:union.ndltd.org:VTETD/oai:vtechworks.lib.vt.edu:10919/97126 |
| Date | 03 March 2020 |
| Creators | Lan, Qing |
| Contributors | Industrial and Systems Engineering, Jin, Ran, Robertson, John L., Wernz, Christian, Lau, Nathan |
| Publisher | Virginia Tech |
| Source Sets | Virginia Tech Theses and Dissertation |
| Detected Language | English |
| Type | Dissertation |
| Format | ETD, application/pdf |
| Rights | In Copyright, http://rightsstatements.org/vocab/InC/1.0/ |
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