Panniculectomy at the Time of Living Donor Renal Transplantation: An Eight Year Experience

L. M. Ngaage¹, A. Elegbede², K. K. Tasidina¹, S. Gebran³, E. Rada¹, A. J. Nam³, J. R. Scalea⁴, S. Niederhaus⁴, D. Singh¹, J. S. Bromberg⁴, S. T. Bartlett⁴, Y. M. Rasko¹

¹Department of Plastic Surgery, University of Maryland Medical Center, Baltimore, MD, ²Department of Plastic & Reconstructive Surgery, Johns Hopkins Hospital / University of Maryland Medical Center, Baltimore, MD, ³Division of Plastic & Reconstructive Surgery, R Adams Cowley Shock Trauma Center, Baltimore, MD, ⁴Department of Transplant Surgery, University of Maryland Medical Center, Baltimore, MD

Meeting: 2019 American Transplant Congress

Abstract number: C360

Keywords: Kidney transplantation, Obesity, Outcome, Post-operative complications

Topic:

Session Information

Session Name: Poster Session C: Surgical Issues: All Organs

Date: Monday, June 3, 2019

Session Time: 6:00pm-7:00pm

Presentation Time: 6:00pm-7:00pm

Location: Hall C & D

*Purpose: Removal of the pannus, or panniculectomy, can be performed as a prophylactic procedure preceding renal transplantation to enable obese patients to meet criteria for renal transplantation. No literature exists on the combined renal transplant and panniculectomy surgery. We describe our eight-year experience performing panniculectomy concurrent with living donor renal transplantation.

*Methods: Following Institutional Review Board approval, a retrospective chart review of all patients who had undergone a combined living donor renal allotransplantation-panniculectomy (LRT-PAN) at a university-affiliated hospital in 2010-2018 was conducted. Data was collected on patient demographics, allograft survival and function, complications, and length of hospital stay. Major complications were defined as complications that required surgical intervention.

*Results: 58 patients underwent LRT-PAN. All grafts survived; 90-day mortality rate was 2% (1 patient died from medical complications). Wound complication rate was 24%; the majority of wound complications were minor (72%). Readmission rate of 52% with medical causes as the most common reason for readmission (45%), followed by wound concerns (32%) then graft complications (23%). Body mass index, diabetes status, and previous immunosuppression did not influence the wound complication rate or 90-day readmission (p>0.05). Median length of stay was 4 days with a mean operative duration of 363 minutes. Graft function remained stable at one year.

*Conclusions: Panniculectomy can safely be performed at the time of renal transplant with a complication rate similar to or less than that of staged transplant-panniculectomy described in the literature. This removes the interval between surgeries and allows patients to begin life-extending treatment earlier. Thus, combining these procedures is superior to the current staged method and it is a promising therapy for patients with end stage renal disease and an abdominal pannus which otherwise may be considered inhibitory to renal transplantation.

To cite this abstract in AMA style:

Ngaage LM, Elegbede A, Tasidina KK, Gebran S, Rada E, Nam AJ, Scalea JR, Niederhaus S, Singh D, Bromberg JS, Bartlett ST, Rasko YM. Panniculectomy at the Time of Living Donor Renal Transplantation: An Eight Year Experience [abstract]. Am J Transplant. 2019; 19 (suppl 3). https://atcmeetingabstracts.com/abstract/panniculectomy-at-the-time-of-living-donor-renal-transplantation-an-eight-year-experience/. Accessed June 15, 2021.

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