Editors' ChoiceImaging

Lights, Microscope, Action!

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Science Translational Medicine  17 Sep 2014:
Vol. 6, Issue 254, pp. 254ec162
DOI: 10.1126/scitranslmed.3010410

Like photographers examining their proofs for that perfect image, pathologists often seek the optimized image of fixed biopsy tissues to identify pathology and make the diagnosis. But, what if biopsy tissues could be imaged in real time while the cells were still alive with their cellular functions intact? Such capability would be invaluable to organ donation and transplantation, when time-critical evaluation of organ health can make the difference between success and failure.

Ashraf and colleagues demonstrated that live imaging of fresh biopsies is indeed possible and can yield important information regarding tissue injury and health. They used fluorescent live-tissue staining combined with spinning disk confocal microscopy to image the cellular function of living rat and mouse kidney tissue biopsies. Biopsy tissues were first exposed to cell permeation and cold storage and imaged by using a combination of reporter stains, which highlighted cellular structure and cell viability. As expected, living and dead cells were easily distinguished before and after membrane permeation and exposure to cold. Subtle cellular injury was also identified by using a kidney ischemia-reperfusion model in which the blood vessels feeding one kidney were clamped for 35 min and released, while the opposite kidney served as a healthy control. Again, fine-needle biopsies were obtained from both kidneys, and images were obtained within 30 min by using living confocal microscopy techniques. Increased reactive oxygen species and collapse of intracellular mitochondrial membrane potentials were seen in living tissue taken from the damaged kidney.

Quantification of cellular function and its relevance to whole-organ function will need to be integrated into this real-time imaging technique before it can be applied to transplant surgery. Nevertheless, using live confocal imaging to evaluate organ function will continue to advance the field of transplant medicine.

M. I. Ashraf et al., Biopsychronology: Live confocal imaging of biopsies to assess organ function. Transpl. Int. 27, 868–876 (2014). [Abstract]

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