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

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 r...

Full description

Saved in:
Bibliographic Details
Published in:American journal of transplantation 2019-08, Vol.19 (8), p.2284-2293
Main Authors: Ngaage, Ledibabari M., Elegbede, Adekunle, Tadisina, Kashyap K., Gebran, Selim G., Masters, Brian M., Rada, Erin M., Nam, Arthur J., Scalea, Joseph R., Niederhaus, Silke V., Singh, Devinder, Bromberg, Jonathan S., Bartlett, Stephen T., Rasko, Yvonne M.
Format: Article
Language:English
Subjects:
Abdominoplasty - methods
Adult
Aged
Body Mass Index
clinical research/practice
Demography
Diabetes mellitus
Female
Follow-Up Studies
Glomerular Filtration Rate
Humans
Immunosuppression
Kidney Failure, Chronic - complications
Kidney Failure, Chronic - surgery
Kidney Function Tests
Kidney transplantation
Kidney Transplantation - methods
kidney transplantation/nephrology
kidney transplantation: living donor
Kidney transplants
Living Donors - supply & distribution
Male
Middle Aged
Obesity
Obesity - complications
Obesity - surgery
Patients
Postoperative Complications
Preoperative Care
Prognosis
Retrospective Studies
Risk Factors
Surgery
surgical technique
Transplants & implants
Wounds
Young Adult
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary: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. This study investigates the feasibility of performing panniculectomy at the time of living donor renal transplant and finds the combined surgery to be safe and efficacious in carefully selected patients with a focal abdominal pannus.
ISSN:1600-6135
1600-6143
DOI:10.1111/ajt.15285