3D model built on images aids kidney transplant for toddler

Technology is better than conventional imaging alone in preparing for surgery and during the procedure, surgeons say.

Three-dimensional models are being used in addition to conventional medical imaging in more complex medical cases, such as a recent procedure in which a father’s kidney was transplanted into his 2-year-old son.

The combination of the technologies in pre-planning for anatomically complex procedures can help surgeons anticipate potential problems and physically practice on how to achieve successful surgeries with different-aged patients.

In the most recent case, surgeons at Guy’s and St. Thomas’ NHS Foundation Trust in London, are using 3D printing technology to improve the success rates of complex organ transplantation in young children—most recently, when Brendan Clark’s kidney was transplanted into his son, Dexter. It is the first Trust to use 3D printed models to pre-plan the transplantation of an adult kidney into a small child with anatomical complexities.

Typically, conventional medical imaging is used in the pre-surgical planning process for surgeries such as this—however, these often have limitations. To enhance the chances for success, the surgeons used a precision, multi-material Stratasys 3D printer to use data from the conventional images to produce two intricate, patient-specific models for pre-surgical preparations. Surgeons worked with clinical scientists from the Trust’s medical physics department who specialize in medical imaging, converting CT scans into anatomically accurate, multi-material 3D models.

Two factors complicated the Clark transplant—Dexter weighed less than 25 pounds, significantly increasing the risk, surgeons say. Also, the father’s kidney was much larger than that of the average adult male, raising questions about the feasibility and safety of implanting the donor kidney.

The surgeons used a precision, multi-material Stratasys 3D printer Tri Tech 3D to produce two intricate, patient-specific models for pre-surgical preparations.

“These helped us appreciate aspects such as depth perception and space within the baby’s abdomen, which can often be difficult to ascertain when looking at conventional imaging,” says Pankaj Chandak, transplant register at the facility.

With 3D printed models of the patient, the need for surgical exploration can be reduced, because the team can safely determine the optimal surgical approach in the pre-planning stages before the patient is on the operating table. In Dexter’s case, the 3D printed models were also taken into the operating suite for the procedure and reviewed by transplant surgeons who were able to use the models during the operation to assess the best way in which the donor kidney would lie and fit into the child’s abdomen.

“This technology has the potential to really enhance and aid our decision-making process both during pre-surgical planning and in the operating room, and therefore can help in the safety of what is a very complex operation and improve our patient care,” Chandak concludes.

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