Page 32 - 3DA Mag N° February2018 -EN+

MEDICINE

How does 3D printing enable doctors

to achieve a kidney transplant?

Recently in Belfast (Ireland), surgeons used a 3D printed model of a kidney to carry out a
complex transplant operation on a young mother. It was a premiere in the complete excision
of a Bosniak 2F renal cyst from a donor kidney without the requirement of revision surgery.

an improved quality of life and the
opportunity to see her child grow up.
Indeed, the 3D printing technology
enables an extra level of unders-
tanding that isn’t possible with 2D or
3D images on screen.
Advantages in terms of costs

In this case, using of 3D printing
helped to plan the surgery in detail,
considering the best approach,
as well as the potential problems,
before stepping into the operating
room. Furthermore, as far as costs
are concerned, the average cost for
auline Fenton, 22, was living allotransplantation into Pauline’s a patient on dialysis is over £30,000
with end stage kidney disease body.
Pand was wholly reliant on per year. This cost has been reduced
to £5000 per year in post-transplant
dialysis. Her 45-year-old father, Consultant Transplant Surgeon Tim management costs. By exploiting
William was confirmed to be a Brown explained: “in this case, our tools such as 3D printing, complex
suitable living donor, unfortunately, donor’s kidney was the best possible transplants are now possible and a
he was blood group incompatible. option for his daughter’s life saving
transplant, so we had to ensure great number of people’s lives can
In addition, doctors discovered the precise and complete excision be saved.
father’s donor kidney was potentially of the cyst to retrieve maximum Daniel Crawford, founder of axial3D,
cancerous, which added another healthy tissue for transplantation”. the company which produced the
level of complexity in the procedure The consultant explained that they model for Mr Brown said: “now that
that was already complex. As the planned and rehearsed the surgery 3D prints are available via the NHS
cyst would first require treatment precisely, using an exact replica of in Northern Ireland, we look forward
before the incompatible transplant the donor’s kidney containing the to supporting more surgeons and
could proceed, surgeons at Belfast size and position of cyst, so they patients with this technology.” The
City Hospital decided to use a 3D knew the precise procedure required company aims at working with
printed replica model of the donor in the operating theatre. surgeons with the aim to improve
kidney (printed exactly from his CT patient outcomes; reduce operating
scans). As far as results are concerned,
the team completely removed the times and ultimately help advance
How did the surgeons carry out Bosniak 2F cyst from the donor surgical education and planning for
the treatment? kidney, confirmed margin clearance the future.
from the pathologist in real time
The team firstly verified the size and subsequently completed an
and placement of the tumour and ABO incompatible transplant to
cyst thanks to the 3D printed replica the donor’s daughter. The recipient
model. Thereafter, they planned and kidney achieved primary graft
prepared for the surgery to remove minutes after transplantation and
the cyst and transplant the kidney kidney function remains excellent
to Pauline. to date.
Technically speaking, the physical This level of insight is not achievable
1:1 scale model of the father’s donor with conventional pre-operative
kidney with existing Bosniak 2F imaging. Furthermore, for the
renal cyst, was used in guiding a consultant, 3D printing played a key
partial nephrectomy and living donor role in helping them to give Pauline

Consultant Transplant Surgeon Tim Brown

Magazine / February 2018