Three-dimensional Liver Model Application for Liver Transplantation

Area of Science:

• Medical Engineering
• Surgical Technology
• Transplant Surgery

Background:

• Organ size mismatch is a significant barrier in pediatric liver transplantation, leading to organ refusal and impacting patient outcomes.
• Current methods for organ assessment may not fully capture anatomical complexities, affecting allocation and donor selection.
• 3D technology offers a potential solution to improve the accuracy of organ evaluation and surgical planning.

Purpose of the Study:

• To evaluate the feasibility and accuracy of patient-specific 3D-printed liver models in pediatric liver transplantation.
• To assess the impact of 3D models on organ allocation and living donor selection.
• To determine the effect of 3D model utilization on living donor hepatectomy outcomes.

Main Methods:

• A prospective, multicenter study involving pediatric liver transplant candidates and living donors (January 2020-February 2023).
• Utilization of patient-specific 3D-printed liver models for anatomical planning, intraoperative evaluation, and surgical navigation.
• Propensity score matching with a retrospective cohort for comparative analysis of outcomes.

Main Results:

• 3D models demonstrated high accuracy, with a median percentage error of -0.6% and strong correlation (Pearson's R = 0.96) to actual liver explant volumes.
• Living donor hepatectomy in the 3D model group showed significantly lower central line utilization, shorter hospital stays, and reduced complication rates.
• Patient and graft survival rates were comparable between groups, indicating safety and efficacy.

Conclusions:

• 3D-printed liver models provide a highly accurate volumetric assessment compared to actual explants, aiding in organ allocation.
• The integration of 3D models into the perioperative workflow is a feasible and safe adjunct for decision-making in liver transplantation.
• 3D technology positively impacts living donor hepatectomy outcomes, enhancing the overall transplant process.