Three Dimensional Printed Lung/Thorax Models - An Aid to Lung Transplant Size Matching in Fibrotic Lung Disease

• Published in: The Journal of heart and lung transplantation Vol. 40; no. 4; p. S328
• Main Authors: Khoshbin, E., Sivarajah, S., Coey, J., Clark, S.
• Format: Journal Article
• Language: English
• Published: Elsevier Inc 01.04.2021
• ISSN: 1053-2498; 1557-3117
• DOI: 10.1016/j.healun.2021.01.923

Patients with interstitial lung fibrosis have a small chest cavity and present a challenge for accurate size matching of donor lungs to the recipient. Presently donor-recipient size matching relies on clinical judgement and experience to avoid under or over sizing. Both are associated with poorer clinical outcomes in recipients. We have therefore developed a three dimensional (3D) printed objective aid to lung procurement for use in this group of patients. The objective of this project was to produce a patient specific 3D model of the recipients lungs and thorax for patients with interstitial lung fibrosis awaiting lung transplantation. This 3D model would be then sterilised and taken to the procurement in order to directly aid size matching of donor to recipient. Recipients CT scans were subjected to data transformation to produce a 3D printing file. This involved tracing of the CT images using Osirix software. This allowed the 3D printing of an actual size model of the individual patients lungs. A vacuum moulding of the anterior and posterior halves of the lungs was then be cast to replicate the patients thorax to assist with onsite size matching of donor to recipient lungs (Pictures). Chemical sterilisation tests have been successful allowing us to take a specific patient model to organ procurement. This would allow direct assessment of the organs size at the time of retrieval and a reduction in the incidence of size mismatching and better clinical outcomes. The subjective and real time assessment of the lung volume adds another dimension to make the assessment of lung volumes more accurate. This objective tool for the retrieval surgeon supplements the largely objective lung volume measurements currently used. This helps the implanting surgeon in deciding on risk of lung volume reduction surgery for a particular recipient or to offer the lungs to either another recipient or potentially to another transplant centre.