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NORMAN, Okla. – Each year, thousands of patients in the United States wait for a liver transplant, while transplant teams must make rapid and difficult decisions about whether donor organs are suitable for use. Many of those livers, particularly from older or medically complex donors, require careful evaluation before transplantation, and current assessments often sample only a small region of the organ. In response, a team of University of Oklahoma researchers has developed a noninvasive imaging approach that could help transplant teams evaluate donor livers more comprehensively and make faster, more informed decisions.
Qinggong Tang, Ph.D., leads the OU research lab that recently published these findings in Science Translational Medicine. Doctors currently determine liver health primarily through biopsies, in which a small piece of tissue is sliced and examined under a microscope. However, this is an invasive procedure and cannot account for the health of the entire liver. Tang said this can lead to cases where doctors may not feel comfortable using a liver for a transplant if the biopsy’s results don’t feel conclusive enough.
“A small biopsy sample may not fully represent the condition of the entire liver,” said Tang, who is an associate professor in the Gallogly College of Engineering’s Peggy and Charles Stephenson School of Biomedical Engineering. “Our goal is to develop a technology that can evaluate the liver more comprehensively and provide clinicians with a clearer picture of overall organ health.”
To address this, Tang and his team are studying livers using polarization-sensitive optical coherence tomography (PS-OCT). Optical coherence tomography is widely used in retinal imaging, and polarization-sensitive OCT adds another layer of contrast by measuring tissue organization. Tang’s team is adapting this high-resolution, noninvasive imaging approach for donor liver evaluation, where it has not been widely used.
The researchers developed a portable PS-OCT imaging system designed to support timely scanning in clinical and operating room settings. The team also created AI-driven image analysis tools to process the scans and identify key liver health indicators, including hepatic steatosis and inflammation.
To evaluate whether PS-OCT findings reflect clinically meaningful liver health indicators, Tang’s team partnered with OU Health to compare imaging results with biopsy findings and post-transplant clinical outcomes from donor livers evaluated through established clinical decision-making pathways. The team found that PS-OCT imaging features were associated with pathology findings and early indicators of liver function after transplantation.
“By pairing our imaging data with pathology results, we can train AI models to recognize features associated with liver health,” said Chongle Pan, Ph.D., a study co-author and professor in Gallogly’s School of Computer Science. “The long-term goal is to provide clinicians with a faster, more comprehensive tool that could complement biopsy and, in some cases, reduce the need for invasive sampling.”
Tang said PS-OCT’s promise in evaluating liver health could significantly help improve transplant timeliness. Because PS-OCT can scan larger regions of the liver without removing tissue, the method could provide clinicians with a more complete view of donor organ quality. In the future, this may help identify usable organs that might otherwise be declined and support efforts to reduce organ discard.
The team has also continued to increase their findings from their partnership with OU Health. They have gathered data from more than 30 clinical cases, up from five in the published study, and Tang said he aims to reach 200. This would further train their AI model.
The next goal is to develop a multisite clinical study to evaluate the technology across broader patient and donor populations. Tang’s team is collaborating with UT Southwestern Medical Center and Cleveland Clinic and has received interest from other transplant centers.
The project highlights OU’s organ and tissue imaging research core, part of a growing infrastructure that integrates advanced bioimaging, artificial intelligence, pathology and human organ perfusion technologies. This platform provides a translational framework for bringing engineering innovations into real clinical workflows and may be extended beyond liver transplantation to kidney, lung, heart and other organ assessments.
Tang and his team’s work was supported in part by OU’s National Science Foundation-supported ART: InTRO program and the OU Data Institute for Societal Challenges, reflecting the project’s focus on translational impact, artificial intelligence and data-enabled biomedical research.
“This is just the beginning,” said Tang, who also holds an Endowed Stephenson Professorship and is chair of the Translational Stimulation Committee, which supports innovation, entrepreneurship and real-world impact within the school.
“We are actively expanding this approach to other organs, including the kidney and lung. Beyond that, these human organ and tissue platforms allow us to evaluate additional imaging technologies and support a wide range of translational studies. There is a lot of exciting work ahead.”
About the research
The study, “Human donor liver viability evaluation with polarization-sensitive optical coherence tomography,” can be found in Science Translational Medicine at science.org/doi/10.1126/scitranslmed.adv7124.
About the University of Oklahoma
Founded in 1890, the University of Oklahoma is a public research university located in Norman, Oklahoma. As the state’s flagship university, OU serves the educational, cultural, economic and health care needs of the state, region and nation. For more information about the university, visit www.ou.edu.
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Qinggong Tang, Ph.D., is leading a University of Oklahoma research lab studying livers with polarization-sensitive optical coherence tomography. This approach has not been widely used for donor liver evaluation and could help transplant teams make faster, more informed decisions for patients.
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