title: Digital reporting of whole-slide images is safe and suitable for assessing organ quality in preimplantation renal biopsies.
abstract: Digital pathology allows networks of "remote" specialist pathologists to report the findings of preimplantation kidney biopsies. We sought to validate the assessment of preimplantation kidney transplant biopsies for diagnostic purposes using whole-slide images according to the recommendations of the College of American Pathologists. Sixty-two consecutive, previously reported, preimplantation kidney biopsies were scanned using the ScanScope Digital Slide Scanner at 0.5 μm/pixel (20× objective). The slides were assessed for percent glomerulosclerosis, tubular atrophy, interstitial fibrosis and vascular narrowing using the Remuzzi criteria by two pathologists, one using glass slides and the other using the whole-slide images viewed on a widescreen computer monitor. After a 2-week washout period, all of the slides were re-assessed by the same pathologists using the opposite mode of reporting to that used in the first evaluation. Very high glass-digital intraobserver concordance was achieved for the overall score and for individual grades by both pathologists (κ range, 0.841-0.973). The overall scores obtained by both pathologists and using both methods were identical. The times needed to assess the biopsies were 14 minutes when using a light microscope and 18 minutes, including scanning time, which averaged 2 minutes 20 seconds per slide, when using digital microscopy. Digital microscopy is a reliable, fast, and safe method for the assessment of preimplantation kidney biopsies.
authors.affiliation: University and Hospital Trust, Pathology, Department of Diagnostics and Pathology, 37134, Verona, Italy. Electronic address: albino.eccher@ospedaleuniverona.it.
authors.forename: Albino
authors.initials: A
authors.lastname: Eccher
authors.affiliation: Queen Elizabeth Hospital Birmingham, Pathology, Department of Histopathology, B152GW, Birmingham, UK. Electronic address: desley.neil@uhb.nhs.uk.
authors.forename: Desley
authors.initials: D
authors.lastname: Neil
authors.affiliation: University and Hospital Trust, Division of General and Hepatobiliary Surgery, Department of Surgical Science, 37134, Verona, Italy. Electronic address: andrea.ciangherotti@gmail.com.
authors.forename: Andrea
authors.initials: A
authors.lastname: Ciangherotti
authors.affiliation: University and Hospital Trust, Pathology, Department of Diagnostics and Pathology, 37134, Verona, Italy. Electronic address: lucacima85@yahoo.it.
authors.forename: Luca
authors.initials: L
authors.lastname: Cima
authors.affiliation: University and Hospital Trust, Kidney Transplant Center, Department of Surgical Science, 37126, Verona, Italy. Electronic address: luigino.boschiero@ospedaleuniverona.it.
authors.forename: Luigino
authors.initials: L
authors.lastname: Boschiero
authors.affiliation: University and Hospital Trust, Pathology, Department of Diagnostics and Pathology, 37134, Verona, Italy. Electronic address: guido.martignoni@univr.it.
authors.forename: Guido
authors.initials: G
authors.lastname: Martignoni
authors.affiliation: University and Hospital Trust, Pathology, Department of Diagnostics and Pathology, 37134, Verona, Italy. Electronic address: claudio.ghimenton@ospedaleuniverona.it.
authors.forename: Claudio
authors.initials: C
authors.lastname: Ghimenton
authors.affiliation: University and Hospital Trust, Pathology, Department of Diagnostics and Pathology, 37134, Verona, Italy. Electronic address: marco.chilosi@univr.it.
authors.forename: Marco
authors.initials: M
authors.lastname: Chilosi
authors.affiliation: University and Hospital Trust, Department CED, 37134, Verona, Italy. Electronic address: luca.giobelli@ospedaleuniverona.it.
authors.forename: Luca
authors.initials: L
authors.lastname: Giobelli
authors.affiliation: University and Hospital Trust, Neurosurgery and Intensive Care Unit, Department of Surgical Science, 37126, Verona, Italy. Electronic address: laura.zampicinini@ospedaleuniverona.it.
authors.forename: Laura
authors.initials: L
authors.lastname: Zampicinini
authors.affiliation: University and Hospital Trust, Neurosurgery and Intensive Care Unit, Department of Surgical Science, 37126, Verona, Italy. Electronic address: marilena.casartelliliviero@ospedaleuniverona.it.
authors.forename: Marilena
authors.initials: M
authors.lastname: Casartelli
authors.affiliation: University and Hospital Trust, Pathology, Department of Diagnostics and Pathology, 37134, Verona, Italy. Electronic address: matteo.brunelli@univr.it.
authors.forename: Matteo
authors.initials: M
authors.lastname: Brunelli
mesh_terms: D001706:Biopsy; D046148:Donor Selection; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D007668:Kidney / Q000473:pathology*; D007674:Kidney Diseases / Q000473:pathology*; D016030:Kidney Transplantation / Q000379:methods*; D008853:Microscopy; D015588:Observer Variation; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D019113:Telepathology / Q000379:methods*; D014019:Tissue Donors
keywords: Digital pathology; Donor; Kidney biopsies; Organ quality; Transplantation