NHS Trust uses 3D printing for 'world first' transplant operation

A London NHS Trust has used 3D printing to help surgeons successfully transplant a father’s kidney into his two-year old son.

Two-year-old Dexter Clark received the kidney from his father Brendan Clark in a risky operation.

Surgeons at Guy’s and St Thomas’ NHS Foundation Trust used multi-material 3D printing technology from Stratasys to determine whether they could carry out the procedure.  

The operation makes the Trust the first in the world to use 3D printed models to plan for the transplantation of an adult kidney into a small child with anatomical complexities

Even before Dexter was born, doctors knew he would need a kidney transplant and that his father would be the likely donor. However, in order to carry out the transplant, surgeons had to assess whether or not the procedure could be performed. The two major issues were that Dexter weighed less than 10kg, significantly increasing the risk, and that his father’s kidney was much larger than that of the average adult male. Both issues raised questions into the possibility and safety of implanting the donor kidney into Dexter’s abdomen.

Conventional medical imaging is typically used in the pre-surgical planning process, but this has its limitations according to Pankaj Chandak, transplant registrar at Guy’s and St Thomas’ NHS Foundation Trust, who said:

“Using our 3D printer, we worked in collaboration with Nick Byrne and his team – clinical scientists from our medical physics department who specialise in medical imaging.

“They converted patient CT scans into anatomically accurate, multi-material 3D models. 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.

“The ability to print a 3D model of the patient’s anatomy in varying textures, with the intricacies of the blood vessels clearly visible within it, enables us to differentiate critical anatomical relations between structures. The flexible materials also allowed us to better mimic the flexibility of organs within the abdomen for simulation of the surgical environment.”

“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 said.

The pre-surgical models allowed surgeons to determine feasibility of the operation, without having to conduct an invasive surgical procedure on Dexter beforehand. The team were also able to take the 3D models into the operating theatre and use them during the operation to  assess the best way in which the donor kidney would lie and fit into Dexter’s abdomen.

Emily Clark, Dexter’s mother, said, “Since the transplant, Dexter is a changed boy, eating solid food for the very first time. We always knew the operation would be complicated but knowing that the surgeons had planned the surgery with 3D models that matched the exact anatomy of my husband’s kidney and son’s abdomen, was extremely reassuring. We hope that Dexter’s case will offer other suffering families similar reassurance that cutting-edge technology, such as 3D printing, can help surgeons better treat their loved ones.”

Michael Gaisford, Stratasys’ director of Marketing for Stratasys Healthcare Solutions, said: “Guy’s and St Thomas’ NHS Foundation Trust is pushing the boundaries of what can be achieved with multi-material 3D printing within healthcare. It is a clear demonstration of the ability for 3D printing to enable physicians to better plan, practice and determine the optimal surgical approach. We are delighted to see Dexter has fully recovered and hope many other children can benefit from such forward-thinking applications of our technology.”

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