A Multidisciplinary Technique for Concurrent Panniculectomy-Living Donor Renal Transplantation

Area of Science:

• Surgical Innovation
• Transplant Surgery
• Plastic Surgery

Background:

• Panniculectomy concurrent with renal transplantation is a safe option for patients with large pannus.
• This combined procedure requires meticulous interdisciplinary team coordination.

Purpose of the Study:

• To describe the technique, timing, and sequence of combined renal transplantation and panniculectomy.
• To evaluate the safety and outcomes of this combined surgical approach.

Main Methods:

• Retrospective chart review of adult patients undergoing simultaneous living donor renal transplantation-panniculectomy (2015-2019).
• A multi-team approach involving urology, transplant, and plastic surgery.
• Panniculectomy performed first, followed by kidney transplantation, and completed with wound closure by plastic surgery.

Main Results:

• Twenty patients (12 male, 8 female, mean age 55, BMI 35 kg/m²) were included.
• Mean operative duration was 394 minutes, with 17% for panniculectomy.
• 100% graft survival and primary graft function at 90 days, with 25% wound complications and 15% reoperation rate.

Conclusions:

• Performing panniculectomy first provides optimal surgical exposure for transplantation.
• Plastic surgery-led wound closure may reduce complications in obese end-stage renal disease patients.
• Further research is needed to assess the cost-benefit of this combined procedure.