Impact of panniculectomy on transplant candidacy of obese patients with chronic kidney disease declined for kidney transplantation because of a high-risk abdominal panniculus: A pilot study

Surgery
Christoph TroppmannMichael S Wong

Abstract

Obese patients can develop a large lower abdominal panniculus (worsened by significant weight loss). Patients with advanced chronic kidney disease (CKD) affected by this obesity-related sequela are not infrequently declined for kidney transplantation because of the high risk for serious wound-healing complications. We hypothesized that pretransplant panniculectomy in these patients would (1) render them transplant candidates, and (2) result in low posttransplant wound-complication rates. In a pilot study, adult patients with CKD who had a high-risk panniculus as the only absolute contraindication to kidney transplantation subsequently were referred to a plastic surgeon to undergo a panniculectomy in order to become transplant candidates. We analyzed the effect of panniculectomy on (1) transplant candidacy and (2) wait list and transplant outcomes (04/2008-06/2014). Overall, 36 patients had panniculectomy (median prior weight loss, 38 kg); all were wait-listed with these outcomes: (1) 22 (62%) patients were transplanted; (2) 7 (19%) remain listed; and (3) 7 (19%) were removed from the wait list. Survival after panniculectomy was greater for those transplanted versus not transplanted (at 5 years, 95% vs 35%, respectively; P = .00...Continue Reading

References

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Citations

Jul 7, 2018·Plastic and Reconstructive Surgery·Rami S KantarDaniel J Ceradini
Jan 4, 2019·Experimental and Clinical Transplantation : Official Journal of the Middle East Society for Organ Transplantation·Anne-Elisabeth HengMikel Prieto
Mar 3, 2020·Annals of Plastic Surgery·Ledibabari M NgaageYvonne M Rasko
Oct 4, 2019·Experimental and Clinical Transplantation : Official Journal of the Middle East Society for Organ Transplantation·Paola Karina GarcíaLuis Eduardo Bermúdez
Dec 23, 2017·Aesthetic Plastic Surgery·Leela S MundraSeth R Thaller
Feb 6, 2019·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·Ledibabari M NgaageYvonne M Rasko
Nov 18, 2021·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Gabriel C OniscuEvi V Nagler

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