Three-dimensional Liver Model Application for Liver Transplantation

被引：2

作者：

Sanchez-Garcia, Jorge ^{[1
,2
]}

Lopez-Verdugo, Fidel ^{[1
,2
]}

Shorti, Rami ^{[3
]}

Krong, Jake ^{[4
]}

Kastenberg, Zachary J. ^{[1
,5
]}

Walters, Shannon ^{[6
]}

Gagnon, Andrew ^{[2
]}

Paci, Philippe ^{[2
]}

Zendejas, Ivan ^{[2
]}

Alonso, Diane ^{[2
]}

Fujita, Shiro ^{[1
,2
]}

Contreras, Alan G. ^{[1
,2
]}

Botha, Jean ^{[1
,2
]}

Esquivel, Carlos O. ^{[7
]}

Rodriguez-Davalos, Manuel I. ^{[1
,8
]}

机构：

[1] Intermt Primary Childrens Hosp, Liver Ctr, Salt Lake City, UT 84113 USA

[2] Intermt Med Ctr, Abdominal Transplant Serv, Murray, UT USA

[3] Intermt Hlth, Emerging Technol, Murray, UT USA

[4] Intermt Med Ctr, Transplant Res Dept, Murray, UT USA

[5] Univ Utah, Sch Med, Div Pediat Surg, Salt Lake City, UT USA

[6] Stanford Univ, Sch Med, Dept Radiol, Stanford, CA USA

[7] Stanford Univ, Lucile Packard Childrens Hosp, Div Abdominal Transplantat, Sch Med, Stanford, CA USA

[8] Univ Utah, Sch Med, Div Transplant Surg, Salt Lake City, UT USA

来源：

TRANSPLANTATION | 2024年 / 108卷 / 02期

关键词：

GRAFT SIZE; RECIPIENT SURVIVAL; VOLUME; CHILDREN; OUTCOMES; ADULT; SEGMENTATION; FORMULA; NETWORK; IMPACT;

D O I：

10.1097/TP.0000000000004730

中图分类号：

R392 [医学免疫学]; Q939.91 [免疫学];

学科分类号：

100102 ;

摘要：

Background. Children are removed from the liver transplant waitlist because of death or progressive illness. Size mismatch accounts for 30% of organ refusal. This study aimed to demonstrate that 3-dimensional (3D) technology is a feasible and accurate adjunct to organ allocation and living donor selection process. Methods. This prospective multicenter study included pediatric liver transplant candidates and living donors from January 2020 to February 2023. Patient-specific, 3D-printed liver models were used for anatomic planning, real-time evaluation during organ procurement, and surgical navigation. The primary outcome was to determine model accuracy. The secondary outcome was to determine the impact of outcomes in living donor hepatectomy. Study groups were analyzed using propensity score matching with a retrospective cohort. Results. Twenty-eight recipients were included. The median percentage error was -0.6% for 3D models and had the highest correlation to the actual liver explant (Pearson's R = 0.96, P < 0.001) compared with other volume calculation methods. Patient and graft survival were comparable. From 41 living donors, the median percentage error of the allograft was 12.4%. The donor-matched study group had lower central line utilization (21.4% versus 75%, P = 0.045), shorter length of stay (4 versus 7 d, P = 0.003), and lower mean comprehensive complication index (3 versus 21, P = 0.014). Conclusions. Three-dimensional volume is highly correlated with actual liver explant volume and may vary across different allografts for living donation. The addition of 3D-printed liver models during the transplant evaluation and organ procurement process is a feasible and safe adjunct to the perioperative decision-making process.

引用

页码：464 / 472

页数：9

共 49 条

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