Early Experience With Body Contouring Procedures in Patients With End-Stage Renal Disease Awaiting Renal Transplant

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INTRODUCTION: Patients with (end-stage renal disease) ESRD often have many medical comorbidities, posing a higher risk for any surgical procedure. Obese patients are asked to lose weight to become more acceptable renal transplant candidates. Unfortunately, this often results in a panniculus and excess ptotic skin with accompanying functional and aesthetic concerns. We report our early experience in body contouring procedures in patients with ESRD who underwent massive weight loss. METHODS: Three patients with ESRD on the renal transplant waitlist at UC Davis Medical Center opted for elective body contouring procedures before their transplant surgery. All 3 patients were determined by the transplant team to have a high-risk panniculus and were referred to plastic surgery for panniculectomy before renal transplant. Two of the patients had concurrent lower body lift with panniculectomy, and the third patient underwent modified upper body lift with gynecomastia surgery 7 months after the initial panniculectomy. RESULTS: The mean age of the group was 49 (range = 40-62) years, including 1 male and 2 female patients. The average body mass index of the group was 25.6 (range = 22.8-31.8), and all 3 patients had massive weight loss, with a mean BMI drop of 28.1 (range = 24.2-34.9). Postoperatively, only 1 patient experienced minor wound healing delay, which resolved 3 months after surgery with debridement in clinic and local wound care. CONCLUSIONS: In our early experience, we have seen that body contouring surgery in patients with ESRD awaiting renal transplant has an acceptable and manageable risk profile. By making minor modifications to preoperative, intraoperative, and postoperative routines, body contouring procedures can be safely performed in this patient population and can significantly decrease the functional and aesthetic problems caused by excess skin, resulting in improved body image and quality of life.

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