Improved graft survival by using three-dimensional printing of intra- abdominal cavity to prevent large-for-size syndrome in liver transplantation

Abstract Background In liver transplantation (LT), large-for-size syndrome is not common but can result in fatal outcome. To prevent such fatal outcome, we manufactured 3-D printed intra-abdominal cavity to give intuitive understanding of the sizes of the graft and patient’s abdomen in patients with small body size between July 2020 to February 2022. Methods Clinical outcomes were compared between patients using our 3-D model during LT and patients who underwent LT without 3-D model by using 1:5 ratio propensity score-matched analysis. Results After matching, total 20 patients using 3-D printed abdominal cavity model and 100 patients of 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 3-D printed group was similar to the control group (p = 0.665) but graft survival was significantly superior in 3-D printed group than the control group (p = 0.034). Conclusion Since it showed better graft survival as well as low cost and short production time, our 3-D printing protocol can be a feasible option for patients with small abdominal cavity to prevent large-for-size syndrome after LT.