Panniculectomy Outcomes in Patients with End-Stage Renal Disease in Preparation for Renal Transplant

Mundra, Leela S.; Rubio, Gustavo A.; AlQattan, Husain T.; Thaller, Seth R.

doi:10.1007/s00266-017-1043-4

Cited by 8 publications

(8 citation statements)

References 15 publications

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“…21,[28][29][30][31] Graft complication rates were acceptable, based on the literature. 8,20,28,30,32 The presence of a wound complication did not increase the likelihood of developing a graft complication, contrary to the literature. 32,33 However, we suggest that the relationship described in previous studies may actually be mediated through another variable: attendance, and mortality).…”

Section: Discussioncontrasting

confidence: 58%

“…[8][9][10][20][21][22][23][24][25][26] In a study of patients with a history of solid organ transplant, Zellner et al 27 reported a 14% wound complication rate following plastic surgery procedures. [8][9][10][20][21][22][23][24][25][26] In a study of patients with a history of solid organ transplant, Zellner et al 27 reported a 14% wound complication rate following plastic surgery procedures.…”

Section: Discussionmentioning

confidence: 99%

“…Indeed, we observed a wound complication rate of 24%, which is similar to the reported rates for panniculectomy among those with end-stage renal disease and other high-risk patients. [8][9][10][20][21][22][23][24][25][26] In a study of patients with a history of solid organ transplant, Zellner et al 27 reported a 14% wound complication rate following plastic surgery procedures. Taken together, our data suggest that pharmacologic immunosuppression alone is not a barrier to wound healing.…”

Section: Discussionmentioning

confidence: 99%

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

Ngaage

Elegbede

Tadisina

et al. 2019

American Journal of Transplantation

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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.

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Section: Discussioncontrasting

confidence: 58%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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

Ngaage

Elegbede

Tadisina

et al. 2019

American Journal of Transplantation

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“…This in turn increases the risk of graft loss. A two-stage approach avoids an extended operation time, a large panniculectomy incision, and a higher blood loss followed by the immediate initiation of the posttransplant immunosuppression [10, 32]. There are studies available considering a simultaneous approach.…”

Section: Discussionmentioning

confidence: 99%

“…Minor complications (cellulitis or superficial wound separation) were recorded in 38% of the patients [10]. Mundra et al [32] reported 10.6% of overall wound complications in their analyzed patient cohort. A possible explanation is, that nationwide inpatient samples only report on in-hospital complications, whereas most wound complications might be observed at the postoperative outpatient visits.…”

Section: Discussionmentioning

confidence: 99%

Abdominal Panniculectomy Can Simplify Kidney Transplantation in Obese Patients

et al. 2021

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Background: Obesity is frequently present in patients suffering from end-stage renal disease (ESRD). However, overweight kidney transplant candidates are a challenge for the transplant surgeon. Obese patients tend to develop a large abdominal panniculus after weight loss creating an area predisposed to wound-healing disorders. Due to concerns about graft survival and postoperative complications after kidney transplantation, obese patients are often refused in this selective patient cohort. The study aimed to analyze the effect of panniculectomies on postoperative complications and transplant candidacy in an interdisciplinary setting. Methods: A retrospective database review of 10 cases of abdominal panniculectomies performed in patients with ESRD prior to kidney transplantation was conducted. Results: The median body mass index was 35.2 kg/m2 (range 28.5–53.0 kg/m2) at first transplant-assessment versus 31.0 kg/m2 (range 28.0–34.4 kg/m2) at panniculectomy, and 31.6 kg/m2 (range 30.3–32.4 kg/m2) at kidney transplantation. We observed no major postoperative complications following panniculectomy and minor wound-healing complications in 2 patients. All aside from 1 patient became active transplant candidates 6 weeks after panniculectomy. No posttransplant wound complications occurred in the transplanted patients. Conclusion: Abdominal panniculectomy is feasible in patients suffering ESRD with no major postoperative complications, thus converting previously ineligible patients into kidney transplant candidates. An interdisciplinary approach is advisable in this selective patient cohort.

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Panniculectomy in Morbidly Obese and Post-Massive Weight Loss Patients

Mayer

2023

Body Contouring

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Panniculectomy Outcomes in Patients with End-Stage Renal Disease in Preparation for Renal Transplant

Abstract: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Cited by 8 publications

References 15 publications

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

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

Abdominal Panniculectomy Can Simplify Kidney Transplantation in Obese Patients

Panniculectomy in Morbidly Obese and Post-Massive Weight Loss Patients

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