AMS Spring 2023

Historic Surgery Uses 3D Printing to Prep Transplanting a Kidney from Father to Daughter

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Chris and Lucy Boucher [Image: Sunday Times]

Chris and Lucy Boucher [Image: Sunday Times]

The body is such an interconnected system that when one thing goes wrong, there’s a frightening chance that it will cause a chain reaction leading to damage elsewhere, even in a seemingly unconnected area. The risk increases when the initial problem involves the heart or the brain, which was the case with Lucy Boucher. The Northern Irish child suffered heart failure as a baby when her heart began beating irregularly and too fast – a condition known as supraventricular tachycardia. Although surgery was able to repair her heart, her body had been depleted of oxygen when her heart failed, causing lasting damage to her kidneys.

The outlook wasn’t great – Lucy was looking at a lifetime of dialysis treatments unless she could receive a kidney transplant, which is difficult and risky with a toddler. She was referred to experts at Guy’s and St. Thomas’ Hospital and Great Ormond Street Hospital, both in London. Lucy already had a willing donor who was a match for her blood type – her father, Chris – but the tricky part was transplanting an adult kidney into a toddler’s body.

Pankaj Chandak and Chairman of the Trust Sir Hugh Taylor with the hospital's new 3D printer [Image: Guy's and St. Thomas' Hospital]

Pankaj Chandak and Chairman of the Trust Sir Hugh Taylor with the hospital’s new 3D printer [Image: Guy’s and St. Thomas’ Hospital]

The idea to use 3D printing to help with the surgery came from Pankaj Chandak, a transplant registrar at Guy’s and St. Thomas’ Hospital. The hospital had purchased a 3D printer only a few months before, thanks to a grant from Guy’s and St. Thomas’ Charity. The printer was acquired specifically for the purpose of assisting with transplant surgeries, particularly complicated adult-to-child transplants, and the Bouchers were the first to benefit. Detailed models of Chris’ kidney and Lucy’s abdomen were 3D printed from images taken from their CT and MRI scans.

“When I first saw the models I was taken aback by the level of detail that’s in them,” said Chris Boucher. “It really helped me get an idea in my head of what was going to happen. My first reaction when I saw the 3D printout of my kidney was surprise at how big it was and I wondered how it could possibly fit into Lucy. Seeing the model of her abdomen and the way the kidney was going to be transplanted inside her gave me a clear understanding of exactly what was going to happen. It helped ease my concerns and it was hugely reassuring to know that the surgeons could carry out such detailed planning ahead of the operation.”

The transplant surgery that took place on November 24 at Guy’s and St. Thomas’ was a historic one. It was the first time ever that 3D printing has been used to aid in a kidney transplant from an adult to a child, and it was a success. Having planned ahead, the surgeons knew exactly what they were going to encounter and had already ascertained how they would perform the transplant. The complex surgery lasted four hours, but it likely would have been a lot longer without the prior preparation.

“Our exciting new use of 3D printed models to help plan highly complex kidney transplant surgery in children brings all sorts of important advantages for our patients and the surgical team,” said Chandak. “The most important benefit is to patient safety. The 3D printed models allow informative, hands-on planning, ahead of the surgery with replicas that are the next best thing to the actual organs themselves. This means surgeons are better placed than before to prepare for the operation and to assess what surgical approach will offer the greatest chance of a safe and successful transplant.”

The Boucher family [Image: Guy's and St. Thomas' Hospital]

The Boucher family [Image: Guy’s and St. Thomas’ Hospital]

Lucy and her father are both recovering nicely, and next year she will begin attending nursery as a healthy, active child. She had been receiving dialysis treatments three times per week, but those are a thing of the past now. She can spend the time she would have been in treatment doing much more fun things, like playing with her five-year-old brother Daniel.

“Considering all the potential complications it’s fantastic that everything has gone so well – it’s a massive relief,” said Ciara Boucher, Lucy’s mother. “The transplant is life-changing for Lucy.”

 

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