Abdominelle Pannikulektomie erleichtert die Nierentransplantation bei adipösen Patienten

Promny D, Sebald ATE, Heller KM, Promny T, Arkudas A, Ludolph I, Horch RE (2026)

Publication Type: Journal article

Publication year: 2026

Journal

Handchirurgie, Mikrochirurgie, Plastische Chirurgie Georg Thieme Verlag

Abstract

Background and Objective of the Study Obesity poses an increasing challenge in transplant medicine for patients with end-stage renal disease (ESRD). Despite weight reduction, many of these patients are excluded from kidney transplantation due to a pronounced abdominal panniculus, as this region is prone to wound healing complications and impedes surgical access. The aim of this study was to further evaluate the safety and clinical relevance of abdominal panniculectomy - previously investigated in a pilot study - as a means to improve transplant eligibility in obese ESRD patients. Methods A retrospective analysis was conducted on 16 ESRD patients who underwent panniculectomy between 2016 and 2025 in preparation for a planned kidney transplantation. Collected data included demographic characteristics, perioperative parameters, postoperative complications, and transplant outcomes. Results At the initial presentation to the transplant centre, the mean body mass index (BMI) was 41.1 kg/m (range 28.5- 58.1 kg/m ) and was reduced to 32.1 kg/m (range 28.1- 36.7 kg/m ) prior to panniculectomy. No major complications occurred; only two patients experienced minor wound healing issues that did not require surgical revision. All patients except one were listed as active transplant candidates six weeks after panniculectomy. No postoperative wound complications occurred in the transplanted patients. Conclusion Abdominal panniculectomy is a safe and effective procedure for optimising the surgical conditions in obese ESRD patients. In an interdisciplinary, two-stage approach, it can successfully prepare patients previously ineligible for kidney transplantation. The study highlights the importance of individualised surgical strategies in highly selective high-risk populations.

Authors with CRIS profile

Dominik Promny Department of Plastic and Hand Surgery Adrian Thomas Erwin Sebald Department of Plastic and Hand Surgery Theresa Promny Department of Plastic and Hand Surgery Andreas Arkudas Lehrstuhl für Plastische Chirurgie und Handchirurgie Ingo Ludolph Department of Plastic and Hand Surgery Raymund Horch Professur für Plastische Chirurgie und Handchirurgie

How to cite

APA:

Promny, D., Sebald, A.T.E., Heller, K.M., Promny, T., Arkudas, A., Ludolph, I., & Horch, R.E. (2026). Abdominelle Pannikulektomie erleichtert die Nierentransplantation bei adipösen Patienten. Handchirurgie, Mikrochirurgie, Plastische Chirurgie. https://doi.org/10.1055/a-2763-5531

MLA:

Promny, Dominik, et al. "Abdominelle Pannikulektomie erleichtert die Nierentransplantation bei adipösen Patienten." Handchirurgie, Mikrochirurgie, Plastische Chirurgie (2026).

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