Panniculectomy at the time of living donor renal transplantation: An 8-year experience.
Ledibabari M NgaageAdekunle ElegbedeKashyap K TadisinaSelim G GebranBrian M MastersErin M RadaArthur J NamJoseph R ScaleaSilke V NiederhausDevinder SinghJonathan S BrombergStephen T BartlettYvonne M RaskoPublished in: American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons (2019)
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.
Keyphrases
- obese patients
- end stage renal disease
- body mass index
- newly diagnosed
- bariatric surgery
- type diabetes
- ejection fraction
- metabolic syndrome
- surgical site infection
- weight loss
- chronic kidney disease
- minimally invasive
- healthcare
- prognostic factors
- systematic review
- peritoneal dialysis
- emergency department
- cell therapy
- acute coronary syndrome
- weight gain
- stem cells
- case report
- patient reported outcomes
- wound healing
- physical activity
- mesenchymal stem cells
- coronary artery bypass
- glycemic control