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Panniculectomy in Preparation for Renal Transplantation: A New Indication for an Old Procedure to Reduce Renal Transplantation–Associated Wound Complications

Kuo, Jennifer H. M.D.; Troppmann, Christoph M.D.; Perez, Richard V. M.D.; Wong, Michael S. M.D.

Plastic and Reconstructive Surgery: December 2011 - Volume 128 - Issue 6 - p 1236–1240
doi: 10.1097/PRS.0b013e318230c7b8
Reconstructive: Trunk: Ideas and Innovations

Summary: 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/m2. 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.


Sacramento, Calif.

From the Divisions of Plastic Surgery and Transplant Surgery, University of California, Davis.

Received for publication January 18, 2011; accepted June 13, 2011.

Disclosure:The authors have no financial interest to declare in relation to the content of this article.

Michael S. Wong, M.D.; Department of Surgery, Division of Plastic Surgery, University of California, Davis Medical Center, 2221 Stockton Boulevard, Suite 2123, Sacramento, Calif. 95817,

©2011American Society of Plastic Surgeons