Orthogonal polarization spectral imaging: A new tool in morphologic surveillance in intestinal transplant recipients

Intestinal transplantation (ITx) can be considered a lifesaving procedure in patients with intestinal failure. However, despite improvements in the surgical technique and in patient selection, as well as in immunosuppressive therapy, successful ITx requires an early diagnosis of graft rejection. Acute cellular rejection (ACR) remains the most common and serious complication in clinical ITx. In this scenario frequent endoscopic and histologic surveillance are mandatory to achieve an early diagnosis of rejection and to tailor an effective immunosuppressive regimen. We compared zoom video endoscope (ZVE)[1] and orthogonal polarization spectral (OPS) imaging as techniques to predict qualitative modifications of microscopic architecture and villi microcirculation for the diagnosis of acute cellular rejection in small bowel transplant patients.