Donor Lung EVLP Scoring for Objective Transplant Assessment
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Solution Overview
Problem
Current methods for evaluating donor lungs during ex-vivo lung perfusion are insufficient, particularly in acellular settings, leading to inaccurate assessment of extravascular lung water (EVLW) changes and potentially adverse recipient outcomes due to the lack of objective criteria and subjective evaluation.
Innovation Solution
A system and method using multiple parameters, including direct lung ultrasound evaluation, lung weight, P/F ratio, airway pressure, compliance, lactate level, deflation test, palpation, bronchoscopic findings, and X-ray parameters, to generate a composite score for transplant suitability, utilizing ordinal categorical values and machine learning for objective assessment.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Measurement precision
If conventional tools are used for assessing graft function during EVLP, then the evaluation process is simple, but the measurement precision and reliability are insufficient
Solution Approach 1:
The evaluation system segments the assessment into multiple distinct parameters (lung weight, EVLW, compliance, P/F ratio, visual inspection, bronchoscopy findings, ultrasound evaluation) that can be independently measured and scored. Each parameter is evaluated separately using specific measurement techniques, then aggregated into a composite score. This segmentation enables precise measurement of each aspect while maintaining an organized, systematic approach to the overall evaluation process.
Solution Approach 2:
The system employs a multi-functional evaluation framework that integrates various assessment methods (weight measurement, imaging, functional testing, visual inspection) into a single comprehensive scoring system. This universal approach allows the same evaluation platform to assess multiple aspects of lung quality simultaneously, improving measurement precision without requiring separate complex systems for each parameter.
2Reliability
If subjective evaluation methods are used, then the evaluation process is quick and simple, but the reliability and objectivity are poor
Solution Approach 1:
The system transforms subjective visual assessments into objective parameter-based evaluations by defining specific scoring criteria for each parameter (e.g., compliance measured in mL/cmH2O, P/F ratio as a numerical value, EVLW as a quantified metric). Each parameter is assigned a score based on measurable thresholds and criteria, converting subjective judgments into objective, reproducible data points that enhance evaluation reliability.
Solution Approach 2:
The system incorporates feedback mechanisms where the composite score provides immediate objective feedback on lung transplant suitability. The structured scoring system allows for consistent evaluation across different cases and evaluators, with the aggregate score serving as an objective feedback metric that reduces variability and enhances reliability of the assessment process.
3Measurement precision
If multiple parameters are measured and aggregated, then the evaluation accuracy improves, but the device complexity and data processing requirements increase
Solution Approach 1:
The system segments the complex evaluation into discrete, manageable parameters that can be independently measured and scored. Each parameter (lung weight, EVLW, compliance, P/F ratio, visual inspection, bronchoscopy, ultrasound) is assessed separately using standardized methods, then the individual scores are aggregated into a composite evaluation. This segmentation approach improves assessment accuracy by capturing multiple aspects of lung quality while maintaining systematic organization.
Solution Approach 2:
The system merges multiple independent parameter assessments into a single composite score that provides an integrated evaluation of lung transplant suitability. By combining the scores from various parameters (weight, EVLW, compliance, functional ratios, visual and bronchoscopic findings, ultrasound evaluation) into one aggregate metric, the system simplifies the final decision-making process while retaining the precision benefits of multi-parameter measurement.
Data Source
AI summary
Systems and methods are provided for evaluating a donor lung undergoing ex-vivo perfusion. The system includes a processor and a non-transitory computer readable medium storing executable instructions. The executable instructions include a feature extractor that generates a plurality of parameters representing the donor lung undergoing ex-vivo perfusion. At least one of the plurality of parameters are ordinal categorical parameters that can assume one of a plurality of categorical values. A score calculator is configured to assign a numerical value to each of the ordinal categorical parameters according to the categorical value associated with the parameter and to determine a composite score representing a suitability of the donor lung undergoing ex-vivo perfusion for transplant from the plurality of parameters. A user interface is configured to provide an output representing the composite score to a user at an associated output device.