Accuracy Assessment of a Three-dimensional Printed Model for Surgical Planning of Living Kidney Donors
Keywords:
Transplante de Rim, Doadores Vivos, Cuidados Pré-Operatórios, Impressão Tridimensional, Modelos Anatômicos, Circulação RenalAbstract
Introduction: Three-dimensional (3D) printing has emerged as a promising tool for surgical planning in living donor kidney transplantation, particularly for vascular anatomical assessment of the donor kidney. Objective: To develop a three-dimensional printed model for preoperative evaluation of the kidney donor and to assess its anatomical accuracy based on renal vessel length measurements. Methods: Observational, prospective, multicenter study including 15 kidney donors undergoing laparoscopic nephrectomy with polymer clips. Only left kidney cases with a single vascular trunk were included. 3D models were generated from computed tomography images through digital segmentation and printed in translucent resin. Vessel measurements obtained from the 3D model and from the surgical specimens were compared using an analog caliper. Linear association between measurements was assessed by Pearson's correlation coefficient, and agreement between methods by Bland-Altman analysis. Results: A very strong correlation was observed between renal artery measurements on the 3D model and the surgical specimen (R = 0.91), and a strong correlation for the renal vein (R = 0.85). Paired comparisons showed no statistically significant differences (artery: p = 0.614; vein: p = 0.268). Bland-Altman analysis, considered the reference method for comparing measurement instruments, demonstrated low mean bias with overall acceptable agreement, although with considerably wider limits of agreement for the renal vein (-9.79 to +7.21 mm) compared with the renal artery (-7.53 to +6.57 mm), reflecting greater variability in venous measurements. No severe complications (Clavien-Dindo ≥ 3) occurred among donors. Conclusion: In a sample of donors with single left-sided vessels, the results suggest that the 3D model exhibits strong linear association with actual measurements (Pearson correlation) and acceptable agreement with the surgical specimen (Bland-Altman analysis). These findings are preliminary and should not be generalized without confirmation in larger samples and more complex anatomies.
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Copyright (c) 2026 Bruno de Figueiredo Pimpão, Amanda Simone Camargo de Morais Rocco, Leandro Vieira Lessa, Isabela Raffo Costa, Rogerio de Fraga
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