title: Prevention of late postpneumonectomy complications using a 3D printed lung in dog models.
abstract: OBJECTIVE
  Repositioning of the mediastinum with implantation of a prosthesis seems the favoured approach to treat late complications of pneumonectomy caused by mediastinal shift. However, the traditional prostheses are not designed speciﬁcally for use in the thoracic cavity, sometimes resulting in failure of treatment for many reasons. The aim of our study was to develop a novel prosthesis to promote prevention or treatment of late postpneumonectomy complications.
  
  
  METHODS
  Using 3D printing technology, we created a novel mimetic lung model replicating the native one and then transplanted it into the thoracic cavity of postpneumonectomy dogs to maintain the original position of the mediastinum. Postoperative morbidity and mortality of late complications were compared between transplanted and non-transplanted groups. The safety and feasibility of implanting a 3D printed prosthesis were also evaluated by chest computed tomography (CT) scan and pathological examination.
  
  
  RESULTS
  At the 1-year follow-up, pneumonectomy dogs with 3D printed lungs showed less morbidity and mortality of late complications. CT images indicated dynamic mediastinal shift in pneumonectomy-only dogs with enlarged contralateral lungs. Nevertheless, there was no obvious change in the position of the mediastinum in 3D printed lung transplanted individuals. Moreover, the 3D printed lungs did not cause any additional side effects and revealed good histocompatibility and tolerance of recipients.
  
  
  CONCLUSIONS
  Our experiences indicated the safety, feasibility and efficacy of transplantation with 3D printed lungs for prevention of late postpneumonectomy complications and provided a practical and possibly unique clinical application of 3D printing technology for surgical therapy.
authors.affiliation: Second Department of Thoracic Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China lixj1975@fmmu.edu.cn.
authors.forename: Xiaojun
authors.initials: X
authors.lastname: Li
authors.affiliation: Department of Anesthesia, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China.
authors.forename: Hui
authors.initials: H
authors.lastname: Cai
authors.affiliation: Second Department of Thoracic Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China.
authors.forename: Xiaohai
authors.initials: X
authors.lastname: Cui
authors.affiliation: Department of Pathology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China.
authors.forename: Peilong
authors.initials: P
authors.lastname: Cao
authors.affiliation: Second Department of Thoracic Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China.
authors.forename: Jing
authors.initials: J
authors.lastname: Zhang
authors.affiliation: Second Department of Thoracic Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China.
authors.forename: Gang
authors.initials: G
authors.lastname: Li
authors.affiliation: Second Department of Thoracic Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China.
authors.forename: Jia
authors.initials: J
authors.lastname: Zhang
mesh_terms: D000818:Animals; D004285:Dogs; D005240:Feasibility Studies; D005260:Female; D008168:Lung / Q000033:anatomy & histology / Q000473:pathology / Q000601:surgery*; D008297:Male; D008954:Models, Biological; D011013:Pneumonectomy / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods*; D011183:Postoperative Complications / Q000517:prevention & control*; D066330:Printing, Three-Dimensional / Q000295:instrumentation*; D019736:Prostheses and Implants
keywords: Complications; Mediastinum; Pneumonectomy; Postoperative care; Prosthesis