Annals of Hepato-Biliary-Pancreatic Surgery (한국간담췌외과학회지)

The Korean Association of Hepato-Biliary-Pancreatic Surgery (한국간담췌외과학회)
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Improved graft survival by using three-dimensional printing of intra-abdominal cavity to prevent large-for-size syndrome in liver transplantation

  • Sunghae Park (Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Gyu-Seong Choi (Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Jong Man Kim (Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Sanghoon Lee (Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Jae-Won Joh (Department of Surgery, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine) ;
  • Jinsoo Rhu (Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine)
  • Received : 2024.08.05
  • Accepted : 2024.09.02
  • Published : 2025.02.28
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Abstract

Backgrounds/Aims: While large-for-size syndrome is uncommon in liver transplantation (LT), it can result in fatal outcome. To prevent such fatality, we manufactured 3D-printed intra-abdominal cavity replicas to provide intuitive understanding of the sizes of the graft and the patient's abdomen in patients with small body size between July 2020 and February 2022. Methods: Clinical outcomes were compared between patients using our 3D model during LT, and patients who underwent LT without 3D model by using 1 : 5 ratio propensity score-matched analysis. Results: After matching, a total of 20 patients using 3D-printed abdominal cavity model and 100 patients of the control group were included in this study. There were no significant differences in 30-day postoperative complication (50.0% vs. 64.0%, p = 0.356) and the incidence of large-for-size syndrome (0% vs. 7%, p = 0.599). Overall survival of the 3D-printed group was similar to that of the control group (p = 0.665), but graft survival was significantly superior in the 3D-printed group, compared to the control group (p = 0.034). Conclusions: Since it showed better graft survival, as well as low cost and short production time, our 3D-printing protocol can be a feasible option for patients with small abdominal cavity to prevent large-for-size syndrome after LT.

Keywords

Acknowledgement

The manuscript has been placed in research square as a preprint (https://doi.org/10.21203/rs.3.rs-4157626/v1). This paper was presented as an abstract in Annals of Hepato-Biliary-Pancreatic Surgery in 2023. Ann Hepatobiliary Pancreat Surg 2023;27 Suppl 1:S82.

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