3D Printing Model of Abdominal Cavity of Liver Transplantation Recipient to Prevent Large-for-Size Syndrome

The application of three-dimensional (3D) printing has been increasing and we invented cost-effective and time-saving 3D printed model of intra-abdominal cavity which was utilized in liver transplantation (LT) to prevent large-for-size syndrome. 3D printings were performed on potential adult recipients with small cavity and pediatric patients scheduled for transplantation during July 2020 - September 2021. Based on the computed tomography of the recipient, the inner surface of the abdominal cavity was outlined. The line was marked with a distance of 1 - 3 cm. Then, the outlined data were reconstructed as a 3D model and printed by a fused deposition modeling type 3D printer with a thickness of 2 mm. Pillars and footings for holding the lines were printed and assembled altogether. During deceased donor organ procurement, the size of the graft was compared to that of the printed model. For living donor LT, preoperatively planned liver graft was printed and was physically placed into the 3D printed abdominal cavity. All the 16 cases with 3D printed abdominal cavity showed appropriate fitting of the donor's liver graft to both the 3D printed model and actual recipient's abdominal cavity with no large-for-size syndrome after LT. Median time for manufacturing the model was 576 min (IQR 434 - 680) and estimated median cost for the filament was US$ 1.6 (IQR 1.2 - 1.7). The 3D printed abdominal cavity model can be manufactured in <10 h and was useful for preventing large-for-size syndrome in small-sized recipients.