title: Panniculectomy in preparation for renal transplantation:  a new indication for an old procedure to reduce renal transplantation-associated wound complications.
abstract: End-stage renal disease patients who have lost a significant amount of weight are increasingly being evaluated for kidney transplantation. An abdominal panniculus, almost uniformly observed, creates an area predisposed to wound complications. Consequently, a panniculus may limit a patient's candidacy for transplantation. The authors describe their preliminary experience utilizing panniculectomy as a prophylactic procedure to reduce wound complications following kidney transplantation in patients whose panniculus would exclude them from renal transplantion. A single-institution chart review was conducted of nine patients with end-stage renal disease who underwent a panniculectomy in preparation for transplantation. Clinical outcomes and complications were reviewed. The nine patients included three men and six women with a mean age of 54.5 years and a mean body mass index of 28.3 kg/m. Four patients had diabetes. All patients underwent an uncomplicated panniculectomy, with a mean resected weight of 3.0 kg, and a mean length of hospital stay of 1.75 days. No one required blood transfusions. All patients were followed postoperatively for 3 months. Complications included an abscess and a skin dehiscence treated with local wound care. After recovery, patients were referred to the transplant center for re-evaluation for kidney transplantation. Thus far, four of these nine patients have undergone transplantation. This case series suggests that panniculectomy can be performed safely in patients with end-stage renal disease. Furthermore, panniculectomy gives these otherwise unsuitable kidney transplant candidates access to a life-saving operation.
authors.affiliation: Sacramento, Calif. From the Divisions of Plastic Surgery and Transplant Surgery, University of California, Davis.
authors.forename: Jennifer H
authors.initials: JH
authors.lastname: Kuo
authors.forename: Christoph
authors.initials: C
authors.lastname: Troppmann
authors.forename: Richard V
authors.initials: RV
authors.lastname: Perez
authors.forename: Michael S
authors.initials: MS
authors.lastname: Wong
mesh_terms: D018784:Abdominal Abscess / Q000209:etiology / Q000517:prevention & control* / Q000601:surgery; D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007676:Kidney Failure, Chronic / Q000601:surgery*; D016030:Kidney Transplantation / Q000379:methods*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D015436:Panniculitis, Peritoneal / Q000209:etiology / Q000517:prevention & control* / Q000601:surgery; D011183:Postoperative Complications / Q000209:etiology / Q000517:prevention & control* / Q000601:surgery; D011300:Preoperative Care; D012086:Reoperation; D050507:Subcutaneous Fat, Abdominal / Q000601:surgery*; D013529:Surgical Wound Dehiscence / Q000209:etiology / Q000517:prevention & control* / Q000601:surgery; D014945:Wound Healing / Q000502:physiology