The Impact of Extended Warm Ischemia Time on Late Renal Function After Robotic Partial Nephrectomy

2015 ◽  
Vol 29 (4) ◽  
pp. 444-448 ◽  
Author(s):  
Homayoun Zargar ◽  
Oktay Akca ◽  
Daniel Ramirez ◽  
Luis Felipe Brandao ◽  
Humberto Laydner ◽  
...  
Keyword(s):  
Renal Function ◽  
Partial Nephrectomy ◽  
Warm Ischemia ◽  
Warm Ischemia Time ◽  
Robotic Partial Nephrectomy ◽  
Ischemia Time ◽  
The Impact

Reevaluating Warm Ischemia Time as a Predictor of Renal Function Outcomes After Robotic Partial Nephrectomy

Urology ◽  
2018 ◽  
Vol 120 ◽  
pp. 156-161 ◽  
Author(s):  
Daniel C. Rosen ◽  
Muthumeena Kannappan ◽  
David J. Paulucci ◽  
Alp Tuna Beksac ◽  
Kyrollis Attalla ◽  
...  
Keyword(s):  
Renal Function ◽  
Partial Nephrectomy ◽  
Warm Ischemia ◽  
Warm Ischemia Time ◽  
Robotic Partial Nephrectomy ◽  
Ischemia Time

scholarly journals Anatomic Complexity Quantitated by Nephrometry Score Is Associated With Prolonged Warm Ischemia Time During Robotic Partial Nephrectomy

Urology ◽  
2014 ◽  
Vol 84 (2) ◽  
pp. 340-344 ◽  
Author(s):  
Jeffrey J. Tomaszewski ◽  
Marc C. Smaldone ◽  
Reza Mehrazin ◽  
Neil Kocher ◽  
Timothy Ito ◽  
...  
Keyword(s):  
Partial Nephrectomy ◽  
Warm Ischemia ◽  
Warm Ischemia Time ◽  
Robotic Partial Nephrectomy ◽  
Ischemia Time ◽  
Nephrometry Score

Correlation of the RENAL nephrometry score with warm ischemia time after robotic partial nephrectomy

2012 ◽  
Vol 31 (5) ◽  
pp. 1165-1169 ◽  
Author(s):  
Fatih Altunrende ◽  
Humberto Laydner ◽  
Adrian V. Hernandez ◽  
Riccardo Autorino ◽  
Rakesh Khanna ◽  
...  
Keyword(s):  
Partial Nephrectomy ◽  
Warm Ischemia ◽  
Warm Ischemia Time ◽  
Robotic Partial Nephrectomy ◽  
Ischemia Time ◽  
Nephrometry Score

Use of comparison of cold and warm ischemia during partial nephrectomy in 660 solitary kidneys to investigate the role of nonmodifiable factors in determining ultimate renal function.

2011 ◽  
Vol 29 (7_suppl) ◽  
pp. 321-321
Author(s):  
B. R. Lane ◽  
P. Russo ◽  
R. Uzzo ◽  
A. V. Hernandez ◽  
S. A. Boorjian ◽  
...  
Keyword(s):  
Renal Function ◽  
Partial Nephrectomy ◽  
Statistical Significance ◽  
Warm Ischemia ◽  
Ischemia Time ◽  
Solitary Functioning Kidney ◽  
Modifiable Factors ◽  
Multivariable Analyses ◽  
The Impact ◽  
Functioning Kidney

321 Background: Factors that determine renal function after partial nephrectomy (PN) are not well defined, including the impact of cold vs. warm ischemia and the relative importance of modifiable and non-modifiable factors. We studied these determinants in a large cohort of patients with a solitary functioning kidney undergoing PN. Methods: In 1980–2009, 660 PN were performed at 4 centers for tumor in a solitary-functioning kidney under cold (n=300) or warm (n=360) ischemia. Data were collected in IRB-approved registries; follow- up averaged 4.5 years. Pre- and postoperative glomerular filtration rates (GFR) were estimated via CKD-EPI equation. Results: At 3 months after PN, median GFR decreased by equivalent amounts with cold or warm ischemia (21% vs. 22%, respectively, p=0.7) although median cold ischemic times were much longer (45 vs. 22 min. respectively, p<0.001). In multivariable analyses, increasing age, larger tumor size, lower preoperative GFR, and longer ischemia time were associated with decreased postoperative GFR (p<0.05). When percentage of parenchyma spared was incorporated into the analysis, this factor and preoperative GFR proved to be the primary determinants of ultimate renal function, and duration of ischemia lost statistical significance. Conclusions: This non-randomized comparative study suggests that long-term renal function after PN is determined primarily by the quantity and quality of renal parenchyma that can be preserved. Within the relatively strict parameters of conventional practice, i.e. predominantly short ischemic intervals and liberal use of hypothermia, ischemia time was not an independent predictor of ultimate renal function after PN. Nevertheless, type and duration of ischemia remain the most important modifiable factors during PN, and mandate further study. [Table: see text]

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