Posted on Thursday 7 June 2018
Brendan and Dexter Clark.
A three-year-old boy has received a life-saving kidney transplant thanks to pioneering 3D printing technology used at Guy’s and St Thomas’ NHS Foundation Trust.
Dexter Clark, from Reading, was born with a severe kidney condition which meant he could only eat through a feeding tube.
His dad Brendan wanted to donate his kidney but it was larger than an average adult kidney and the transplant team at Guy’s and St Thomas’ were not sure if it would fit inside Dexter’s small abdomen. The team worked with Nick Byrne from the Trust’s medical physics department to create life-size 3D models of Dexter’s abdomen and Brendan’s kidney using a 3D printer.
Having the models meant that the surgical team could plan for the complex transplant surgery and assess whether it would work before Dexter or Brendan were operated on.
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.
Mr Pankaj Chandak, transplant registrar at Guy’s and St Thomas’, said: “The 3D models helped us appreciate aspects such as depth perception and space within the child’s abdomen, which can often be difficult to determine when looking at conventional imaging.
“The flexible materials also allowed us to better mimic the flexibility of organs within the abdomen in real life.”
In Dexter’s case, the 3D models were also taken into the operating theatre at Evelina London Children’s Hospital – part of Guy’s and St Thomas’ NHS Foundation Trust – on the day of his transplant in January. Brendan’s kidney had been removed at Guy’s Hospital on the same day. Mr Nicos Kessaris, consultant transplant surgeon at the Trust, used the models to assess the best way in which the donor kidney would lie and fit into Dexter’s abdomen.
Dexter’s mum Emily Clark 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.”
Nicos Kessaris added: "This is a very clever use of technology because it allows us to effectively create scale-size replicas of the organ being transplanted and the abdomen that it's going into. In a small number of cases there's a complexity, whether it's with the size of the organ being transplanted or with the vessels, so if there is a complexity this allows us to practise the operation in advance."
In 2015 teams at Guy’s and St Thomas’ pioneered the world’s first use of 3D printing to support the successful transplantation of an adult kidney into a child. The Trust’s 3D printer, made by Stratasys Healthcare Solutions, was funded by Guy’s and St Thomas’ Charity.
Email 3DPrintingsupport@gstt.nhs.uk to contact our medical physics team about the Trust’s 3D printing support services.