*Purpose: Previously, we compared the risk of abdominal wound complications after lateral rectus incision sheath (LRS) versus traditional Gibson incision in a retrospective analysis of 144 consecutive kidney transplants performed by the same surgeon at our institution. There was no difference in overall complication rates 13% vs 5%, respectively. However, we found clear advantage of Gibson over LRS incision for patients >=60 years old (wound complication rate 0 vs 25%, p=0.008), while LRS seemed to be advantageous for younger patients- wound complication rate 7% vs 0, respectively. The goal of this study was to prospectively verify the advantages of LRS and Gibson incision when applied in selected age groups

*Methods: 41 new consecutive patients underwent unilateral, solitary kidney transplantation. Gibson incision was prospectively applied to patients >=60 years old, whereas LRS incision was utilized in younger recipients (<60 year old). All procedures were performed by the same surgeon.

*Results: The majority of patients were on hemodialysis N=36 (88%). 16 (39%) of them were diabetic. Kidney grafts were mostly recovered from brain dead donors (70%) and preserved on the pump (80%). Thymoglobulin was used for immunologic induction (92%). LRS incision was used in N=26 patients with a mean age of 47 (25-58) and a mean BMI of 28 (18-40). Gibson incision was applied in 15 patients with a mean age of 62 (60-72) and a mean BMI of 28 (22-31). Only one patient (2.5%) developed wound dehiscence and infection in our cohort. He was 73 years old male who had a Gibson incision.

*Conclusions: Abdominal incision technique tailored to patients’s age allows reduction in the rate of surgical wound complication after unilateral kidney transplantation. Further studies including larger cohort and longer follow up are warranted to confirm the findings.

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