Posted on Monday 25 January 2016
The transplant is life-changing for Lucy, pictured here with her family.
Surgeons at Guy’s and St Thomas’ have pioneered the world’s first use of 3D printing to support the successful transplantation of an adult kidney into a child.
Two-year-old Lucy Boucher, from Antrim in Northern Ireland, suffered heart failure as a baby when she developed supraventricular tachycardia - meaning her heart was beating irregularly faster than normal. This resulted in her body, including her kidneys, being starved of oxygen.
Having undergone surgery to address her heart condition, Lucy faced the prospect of a lifetime of dialysis treatment due to her kidney failure but that all changed when she was referred to experts at Guy’s and St Thomas’ and Great Ormond Street Hospital. They performed the transplant on 24 November at Great Ormond Street using a kidney donated by her father, Chris Boucher, during a procedure at Guy’s Hospital.
Models of Chris’ kidney and Lucy’s abdomen were produced using Guy’s and St Thomas’ 3D printer so that the surgeons could accurately plan the highly complex operation to minimise the risks.
It is the first time in the world that 3D printing has been used to aid kidney transplant surgery involving an adult donor and a child recipient.
Lucy’s father Chris, an assistant lay minister, says: “When I first saw the models I was taken aback by the level of detail that’s in them. It really helped me get an idea in my head of what was going to happen. My first reaction when I saw the 3D printout of my kidney was surprise at how big it was and I wondered how it could possibly fit into Lucy.
“Seeing the model of her abdomen and the way the kidney was going to be transplanted inside her gave me a clear understanding of exactly what was going to happen. It helped ease my concerns and it was hugely reassuring to know that the surgeons could carry out such detailed planning ahead of the operation.”
Based on measurements obtained through CT and MRI scans, the 3D printer produces a model of liquid plastic, moulded under ultraviolet light to replicate the body parts’ size and density. This enables surgeons to assess the feasibility of the transplant and to rehearse each step of the operation with the 3D models.
Lucy’s surgery at Great Ormond Street lasted four hoursand was led by Guy’s and St Thomas’ consultant transplant surgeon Professor Nizam Mamode.
Mr Pankaj Chandak, a transplant registrar at Guy’s and St Thomas’ whose idea it was to use 3D printouts, says: “Our exciting new use of 3D printed models to help plan highly complex kidney transplant surgery in children brings all sorts of important advantages for our patients and the surgical team.
“The most important benefit is to patient safety. The 3D printed models allow informative, hands-on planning, ahead of the surgery with replicas that are the next best thing to the actual organs themselves. This means surgeons are better placed than before to prepare for the operation and to assess what surgical approach will offer the greatest chance of a safe and successful transplant.”
The 3D printer at Guy’s and St Thomas’ was purchased last year thanks to a grant awarded by Guy’s and St Thomas’ Charity through its Health Innovation Fund. The grant was given in recognition of the wide range of clinical uses that the 3D printer will have and the possible benefits for patients.
Lucy’s mother Ciara, a teacher, says: “We found it amazing that we could see these incredibly detailed models of Chris’ kidney and Lucy’s abdomen.
“Considering all the potential complications it’s fantastic that everything has gone so well – it’s a massive relief. The transplant is life-changing for Lucy.”
The transplant was a success and both father and daughter are recovering well. Previously reliant on receiving dialysis treatment three times a week, Lucy will now be able to start attending nursery next year. Her older brother Daniel, five, is also looking forward to swimming with his baby sister for the first time as until now her medical condition has prevented her doing this.
Michael Wright, Head of Health Investment at Guy’s and St Thomas’ Charity, says: “The 3D printer is one of the many examples of how we are working with the Trust to transform healthcare and radically improve the experience of patients like Lucy. Clinicians from many specialties are embracing the new technology and we expect to see more pioneering uses in the near future.”