3D-printed kidneys help surgeons transplant adult organs into small children
Surgeons used 3D-printed donor kidneys and advanced imaging to successfully transplant adult organs into three pediatric patients without complications. The technique addresses a major surgical bottleneck in pediatric transplantation, potentially expanding the donor pool and reducing wait times for children needing kidney replacements.
Originaltitel: A novel preoperative simulation approach for pediatric kidney transplantation to support donor-recipient size matching using dialysis fluid-enhanced CT imaging and 3D printing.
Karolinska sjukhuset presenterar en ny metod för att motverka storleksmismatchning vid njurtransplantation till små barn. Genom att kombinera 3D-utskrivna donörnjarar med digital simulering i dialysvätskefördubblad CT-bildanalys kan kirurger redan före operation bedöma om donörorganet passar mottagarens anatomi. I studien genomgick tre pediatriska mottagare föroperativ bedömning med segmenterade CT-data från levande donatorer. Den simuleringsbaserade metoden möjliggjorde objektiv spatial matchning mellan giv och mottagare. Alla tre transplantationer slutfördes utan operativa komplikationer relaterade till graftplacering, och orgelfunktionen var tillfredsställande efter sex månader. Tekniken reducerar risken för kirurgiska missöden vid transplantation till mycket små barn och öppnar möjligheter att använda levande donnationer som annars klassificerades som olämpliga. För sjukhus med transplantationsverksamhet kan detta förkorta dialysperioder och förbättra patientutfall.
BACKGROUND: Size mismatch between adult donor kidneys and small pediatric recipients remains a significant technical challenge in pediatric kidney transplantation. To address this, we explored a novel preoperative method to evaluate donor-recipient anatomical compatibility. METHODS: Three pediatric recipients underwent pre-transplant assessments using segmented CT data from living donors to generate patient-specific 3D-printed kidney models. Digital simulation was performed by virtually positioning the donor kidney within fluid-enhanced recipient CT datasets acquired following intraperitoneal dialysis fluid administration. It was hypothesized that this combined approach would enable objective preoperative assessment of spatial fit and surgical feasibility. RESULTS: The preoperative simulation and modeling approach contributed to successful kidney transplantation in all three children without intraoperative complications attributable to graft placement. Postoperative recovery was uneventful, and graft function remained satisfactory at 6-month follow-up. CONCLUSION: The integration of 3D-printed donor kidneys with digital simulation based on dialysis fluid-enhanced CT imaging offers a feasible approach for preoperative donor-recipient size matching in small pediatric recipients. This method may enhance surgical planning, allow safer use of living-donor organs in very small children, and reduce time spent on dialysis.