3D printing leads to a ‘medical first’ during kidney transplant

A 3D printed model of a kidney has helped surgeons in Belfast perform a complex and life-saving transplant operation on a patient.

It is reported to be the first described case of complete excision of a Bosniak 2F renal cyst from a donor kidney without the requirement of revision surgery.

22-year-old Pauline Fenton from Belfast, UK, was living with end stage kidney disease and was wholly reliant on dialysis. Her 45-year-old father, William, was confirmed to be a suitable living donor, but was blood group incompatible.

However, the discovery of a potentially cancerous cyst on William’s donor kidney meant an already complex procedure would have an extra level of complexity. As the cyst would first require treatment before the incompatible transplant could proceed, surgeons at Belfast City Hospital made the decision to use a 3D printed replica model of the father’s donor kidney (printed exactly from his CT scans).

This allowed the team of surgeons to ascertain the size and placement of the tumour and cyst, so the surgical team could plan and prepare for the surgery to remove the cyst and transplant the kidney to the patient.

Consultant transplant surgeon Tim Brown explained: “In this case, our donor’s kidney was the best possible option for his daughter’s life saving transplant, so we had to ensure precise and complete excision of the cyst to retrieve maximum healthy tissue for transplantation.”

Brown continued: “We planned and rehearsed the surgery precisely, using an exact replica of the donor kidney containing the size and position of cyst, so my team knew the precise procedure required in the operating theatre. This level of insight is just not achievable with standard preoperative imaging.

“This father’s gift of life to his daughter proves the benefit of living organ donation but in this case, I’m certain 3D printing also played a part in helping us to give this young mother an improved quality of life and the opportunity to see her child grow up.

“As surgeons, we are highly trained and skilled at what we do, but by having a 3D print of the patient’s anatomy in my hand, I get an extra level of understanding that just isn’t possible with 2D or 3D images on screen. In this case, I could plan the surgery in detail, considering the best approach, as well as the potential problems, before stepping into the operating theatre.”

A kidney transplant not only offers a hugely improved quality and length of life to the patient, but is also financially beneficial for an already stretched health service. The average cost for a patient on dialysis is over £30,000 per year, which is reduced to £5000 per year in post-transplant management costs.

Daniel Crawford, founder of Belfast company axial3D who produced the model said: “We work with surgeons with the core aim to improve patient outcomes; reduce operating times and ultimately help advance surgical education and planning for the future. We’re proud that our technology can have profound positive impacts on improving the quality and length of patients’ lives and we’re delighted that our work provided significant benefit for this family.

“We are delighted to hear that both father and daughter are doing well after their recent operations. Improving patient outcome is at the heart of what we do. It is vital that our amazing surgeons have access to the best and most innovative solutions to support them in planning for very complex procedures. We believe in today’s economy, where cost saving and efficiency is at the forefront of the NHS agenda, 3D printing offers an exciting opportunity for hospitals to reduce costs, elevate care, and most importantly, improve patient outcomes.

“Now that 3D prints are available via the NHS in Northern Ireland, we look forward to supporting more surgeons and patients with this technology.”