The Digital Microscopy in Organ Transplantation: Ergonomics of the Tele-Pathological Evaluation of Renal, Liver and Pancreatic Grafts
Abstract:Introduction: The process to build a better safety
culture, methods of error analysis, and preventive measures, starts
with an understanding of the effects when human factors engineering
refer to remote microscopic diagnosis in surgery and specially in
organ transplantation for the remote evaluation of the grafts. It has
been estimated that even in well-organized transplant systems an
average of 8% to 14% of the grafts (G) that arrive at the recipient
hospitals may be considered as diseased, injured, damaged or
improper for transplantation. Digital microscopy adds information on
a microscopic level about the grafts in Organ Transplant (OT), and
may lead to a change in their management. Such a method will
reduce the possibility that a diseased G, will arrive at the recipient
hospital for implantation. Aim: Ergonomics of Digital Microscopy
(DM) based on virtual slides, on Telemedicine Systems (TS) for
Tele-Pathological (TPE) evaluation of the grafts (G) in organ
transplantation (OT). Material and Methods: By experimental
simulation, the ergonomics of DM for microscopic TPE of Renal
Graft (RG), Liver Graft (LG) and Pancreatic Graft (PG) tissues is
analyzed. In fact, this corresponded to the ergonomics of digital
microscopy for TPE in OT by applying Virtual Slide (VS) system for
graft tissue image capture, for remote diagnoses of possible
microscopic inflammatory and/or neoplastic lesions. Experimentation
included: a. Development of an OTE-TS similar Experimental
Telemedicine System (Exp.-TS), b. Simulation of the integration of
TS with the VS based microscopic TPE of RG, LG and PG applying
DM. Simulation of the DM based TPE was performed by 2
specialists on a total of 238 human Renal Graft (RG), 172 Liver Graft
(LG) and 108 Pancreatic Graft (PG) tissues digital microscopic
images for inflammatory and neoplastic lesions on four electronic
spaces of the four used TS. Results: Statistical analysis of specialist‘s
answers about the ability to diagnose accurately the diseased RG, LG
and PG tissues on the electronic space among four TS (A,B,C,D)
showed that DM on TS for TPE in OT is elaborated perfectly on the
ES of a Desktop, followed by the ES of the applied Exp.-TS. Tablet
and Mobile-Phone ES seem significantly risky for the application of
DM in OT (p
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