"Intra-operative fluorescence imaging using the SPY System has opened a new portal in transplant surgery. Potentially, the days of qualitative assessment of organ appearance, pulse quality, and simple quantitative vascular flow measurements using electromagnetic devices as the sole measurement of an organ transplant are limited", stated Dr. Edmund Q. Sanchez, Assistant Director of Transplantation Services, Baylor University Medical Center in Dallas, Texas. "Our familiarity study of SPY in liver, kidney, and pancreas transplant has demonstrated many potentially beneficial aspects of intra-operatively assessing organ perfusion through imaging. The success of organ transplantation is highly dependent on vascular patency and allograft perfusion. The SPY System has allowed intra-operative visualization of both immediately after reperfusion. The utility of SPY imaging organ transplantation is clearly evident."
The creation and maintenance of adequate blood supply to the newly transplanted organ or "allograft" is critical to the ultimate success of the transplant surgery. Inadequate blood flow can lead to serious complications such as organ thrombosis and allograft failure. The United Network for Organ Sharing reports that while outcomes following transplantation have improved over the years, allograft loss is a problem ultimately confronted by many recipients. For such patients, repeat transplantation often provides the best chance for survival and good health.
Retransplantation offers hope, but previous studies have demonstrated that outcomes following repeat transplantation are, in general, inferior to those observed with first transplants. Since every organ used for repeat transplantation represents an opportunity that cannot be directed to another candidate, the potentially expanding role of retransplantation has been of growing concern. Use of the SPY System may allow surgeons to quickly identify areas of inadequate blood perfusion and potentially make immediate technical revisions which ultimately may save the organ, improve outcomes and reduce the overall costs of recovery.
"Organ transplant is a life saving operation and often offers the only hope for patients suffering from organ failure", stated Dr. Arun Menawat, President and Chief Executive Officer, Novadaq Technologies Inc. "The lack of available donors makes the use of each organ and the success of each transplant critical not only to the patient undergoing the transplant, but for those on the waiting list as well. The use of SPY has been shown to improve the opportunity for technically perfect surgeries which may save the new organ and in turn improve clinical outcomes for patients, prevent life threatening complications, reduce the need for retransplant and overall reduce costs. This new indication for SPY along with previously cleared indications in cardiovascular and plastic and reconstructive surgery gives hospitals a complete solution for performing imaging in the operating room during complex procedures."
According to the United States Organ Procurement and Transplantation Network (OPTN), transplant surgery has saved more than 300.000 lives. In 2006 there were 28.931 transplants performed in the United States and today, more than 94.000 patients suffering from organ failure are on the waiting list. Kidney transplant procedure costs can range widely but most average from $25.000 to $150.000, depending on the extent of kidney disease and whether the patient has a deceased or living donor transplant.
Liver transplant procedure costs can also range, but most average between $100.000 to $400.000, depending on time in the hospital Intensive Care Unit and extent of liver disease before transplantation. Costs can also vary greatly depending on a number of factors including the patient's health at baseline, rate of recovery, any pre-existing conditions and/or potential complications after surgery.
In addition to the clearance for organ transplant, Novadaq has also received a broader indication for the use of SPY in cardiovascular surgery, beyond the originally cleared indication in coronary artery bypass.
Novadaq Technologies Inc. develops and commercializes medical imaging systems and real-time image guided therapies for use in the operating room. Novadaq's proprietary ICG imaging systems can be used to visualize blood vessels, nerves and the lymphatic system during a variety of surgical procedures. Novadaq's SPY Imaging System, commercially available worldwide, enables cardiac surgeons to visually assess coronary vasculature and bypass graft functionality during the course of heart bypass surgery. The SPY System is expandable to include upgrade kits for use during other surgeries such as plastic, reconstructive and organ transplant surgery allowing surgeons to evaluate blood flow and tissue and organ perfusion.
In addition, SPY is ideal for use during urological procedures enabling surgeons to visualize vessels, tumours, the lymphatic system and potentially nerve bundles. Novadaq's OPTTX System is aimed at the diagnosis, evaluation and treatment of wet Age-related Macular Degeneration (AMD) by using the same core imaging technology that is used in the SPY Imaging System. Novadaq also offers the FDA approved PINPOINT endoscopic system for visualizing native tissue fluorescence which allows surgeons to differentiate between healthy and cancerous tissue in the lung during thoracic surgery. Novadaq is also the exclusive United States distributor of PLC Medical's CO2 HEART LASER System for Trans-Myocardial Revascularization (TMR). More company news is available in the VMW April 2005 article Novadaq reports positive results after using its Spy intra-operative imaging system in CABG study.