Panniculectomy at the time of living donor renal transplantation: An 8-year experience

Am J Transplant. 2019 Aug;19(8):2284-2293. doi: 10.1111/ajt.15285. Epub 2019 Mar 2.

Abstract

Panniculectomy can be performed as a prophylactic procedure preceding transplantation to enable obese patients to meet criteria for renal transplantation. No literature exists on combined renal transplant and panniculectomy surgery (LRT-PAN). We describe our 8-year experience performing LRT-PAN. A retrospective chart review of all patients who had undergone LRT-PAN from 2010 to 2018 was conducted. Data were collected on patient demographics, allograft survival and function, and postoperative course. Fifty-eight patients underwent LRT-PAN. All grafts survived, with acceptable function at 1 year. Median length of stay was 4 days with a mean operative duration of 363 minutes. The wound complication rate was 24%. Ninety-day readmission rate was 52%, with medical causes as the most common reason for readmission (45%), followed by wound (32%) and graft-related complications (23%). Body mass index, diabetes status, and previous immunosuppression did not influence wound complication rate or readmission (P = .7720, P = .0818, and P = .4830, respectively). Combining living donor renal transplant and panniculectomy using a multidisciplinary team may improve access to transplantation, particularly for the obese and postobese population. This combined approach yielded shorter-than-expected hospital stays and similar wound complication rates, and thus should be considered for patients in whom transplantation might otherwise be withheld on the basis of obesity.

Keywords: clinical research/practice; kidney transplantation/nephrology; kidney transplantation: living donor/; obesity; surgical technique.

MeSH terms

  • Abdominoplasty / methods*
  • Adult
  • Aged
  • Body Mass Index
  • Female
  • Follow-Up Studies
  • Glomerular Filtration Rate
  • Humans
  • Kidney Failure, Chronic / complications
  • Kidney Failure, Chronic / surgery*
  • Kidney Function Tests
  • Kidney Transplantation / methods*
  • Living Donors / supply & distribution*
  • Male
  • Middle Aged
  • Obesity / complications
  • Obesity / surgery*
  • Postoperative Complications*
  • Preoperative Care*
  • Prognosis
  • Retrospective Studies
  • Risk Factors
  • Young Adult