Significance: The current gold standard for monitoring small intestinal transplant (IT) rejection is endoscopic visual assessment and biopsy of suspicious lesions; however, these lesions are only superficially visualized by endoscopy. Invasive biopsies provide a coarse sampling of tissue health without depicting the true presence and extent of any pathology. Optical coherence tomography (OCT) presents a potential alternative approach with significant advantages over traditional white-light endoscopy. Aim: The aim of our investigation was to evaluate OCT performance in distinguishing clinically relevant morphological features associated with IT graft failure. Approach: OCT was applied to evaluate the small bowel tissues of two rhesus macaques that had undergone IT of the ileum. The traditional assessment from routine histological observation was compared with OCT captured using a handheld surgical probe during the days post-transplant and subsequently was compared with histophaology. Results: The reported OCT system was capable of identifying major biological landmarks in healthy intestinal tissue. Following IT, one nonhuman primate (NHP) model suffered a severe graft ischemia, and the second NHP graft failed due to acute cellular rejection. OCT images show visual evidence of correspondence with histological signs of IT rejection. Conclusions: Results suggest that OCT imaging has significant potential to reveal morphological changes associated with IT rejection and to improve patient outcomes overall.

中文翻译：

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使用手持手术探针的小肠同种异体移植活检的光学相干断层扫描

意义：目前监测小肠移植（IT）排斥反应的金标准是内镜视觉评估和可疑病变活检；然而，这些病变只能通过内窥镜进行表面观察。侵入性活检提供组织健康状况的粗略采样，而没有描述任何病理的真实存在和程度。光学相干断层扫描 (OCT) 是一种潜在的替代方法，与传统的白光内窥镜相比具有显着优势。目的：我们调查的目的是评估 OCT 在区分与 IT 移植失败相关的临床相关形态学特征方面的性能。方法：应用 OCT 来评估两只接受回肠 IT 的恒河猴的小肠组织。将常规组织学观察的传统评估与移植后几天使用手持手术探针捕获的 OCT 进行比较，随后与组织病理学进行比较。结果：报告的 OCT 系统能够识别健康肠道组织中的主要生物学标志。在 IT 之后，一个非人类灵长类 (NHP) 模型遭受了严重的移植物缺血，第二个 NHP 移植物由于急性细胞排斥而失败。OCT 图像显示与 IT 排斥的组织学迹象对应的视觉证据。结论：结果表明，OCT 成像具有揭示与 IT 排斥相关的形态学变化和改善患者整体预后的巨大潜力。