World J Urol DOI 10.1007/s00345-014-1315-4
Original Article
Impact of warm versus cold ischemia on renal function following partial nephrectomy Scott E. Eggener · Melanie A. Clark · Sergey Shikanov · Benjamin Smith · Matthew Kaag · Paul Russo · Jeffrey C. Wheat · J. Stuart Wolf Jr. · Surena F. Matin · William C. Huang · Miriam Harel · Joseph Cambio · Arieh L. Shalhav · Jay D. Raman
Received: 5 March 2014 / Accepted: 29 April 2014 © Springer-Verlag Berlin Heidelberg 2014
Abstract Introduction We evaluated renal function following partial nephrectomy with cold ischemia (CI) versus warm ischemia (WI). Methods Data were collected from 1,396 patients at six institutions who underwent partial nephrectomy for a renal mass with normal contralateral kidney to evaluate percent change in glomerular filtration rate (GFR) at 3–18 months. A multivariate linear regression model tested the association of percent change GFR with clinical, operative, and pathologic factors. Results A total of 874 patients (63 %) underwent PN with CI and 522 (37 %) with WI. All patients undergoing laparoscopic and robotic-assisted partial nephrectomy (n = 443) S. E. Eggener (*) · M. A. Clark · S. Shikanov · A. L. Shalhav Section of Urology, University of Chicago, 5841 South Maryland Avenue, Mail Code 6038, Chicago, IL 60614, USA e-mail: [email protected] B. Smith · J. D. Raman Department of Urology, Pennsylvania State University, Hershey, PA, USA M. Kaag · P. Russo · M. Harel · J. Cambio Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY, USA J. C. Wheat · J. S. Wolf Jr. Department of Urology, University of Michigan, Ann Arbor, MI, USA S. F. Matin Department of Urology, The University of Texas M. D. Anderson Cancer Center, Houston, TX, USA W. C. Huang Department of Urology, New York University, New York, NY, USA
had WI, whereas 92 % of open partial nephrectomy patients (n = 953) had CI. The CI group had a lower mean baseline GFR (72 vs. 80 ml/min/1.73 m2), longer median ischemia time (33 vs. 29 min), and larger mean tumor size (3.2 vs. 2.9 cm) with more advanced pathologic stage (T1b-T3: 25 vs. 16 %) (all p values
Original Article
Impact of warm versus cold ischemia on renal function following partial nephrectomy Scott E. Eggener · Melanie A. Clark · Sergey Shikanov · Benjamin Smith · Matthew Kaag · Paul Russo · Jeffrey C. Wheat · J. Stuart Wolf Jr. · Surena F. Matin · William C. Huang · Miriam Harel · Joseph Cambio · Arieh L. Shalhav · Jay D. Raman
Received: 5 March 2014 / Accepted: 29 April 2014 © Springer-Verlag Berlin Heidelberg 2014
Abstract Introduction We evaluated renal function following partial nephrectomy with cold ischemia (CI) versus warm ischemia (WI). Methods Data were collected from 1,396 patients at six institutions who underwent partial nephrectomy for a renal mass with normal contralateral kidney to evaluate percent change in glomerular filtration rate (GFR) at 3–18 months. A multivariate linear regression model tested the association of percent change GFR with clinical, operative, and pathologic factors. Results A total of 874 patients (63 %) underwent PN with CI and 522 (37 %) with WI. All patients undergoing laparoscopic and robotic-assisted partial nephrectomy (n = 443) S. E. Eggener (*) · M. A. Clark · S. Shikanov · A. L. Shalhav Section of Urology, University of Chicago, 5841 South Maryland Avenue, Mail Code 6038, Chicago, IL 60614, USA e-mail: [email protected] B. Smith · J. D. Raman Department of Urology, Pennsylvania State University, Hershey, PA, USA M. Kaag · P. Russo · M. Harel · J. Cambio Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY, USA J. C. Wheat · J. S. Wolf Jr. Department of Urology, University of Michigan, Ann Arbor, MI, USA S. F. Matin Department of Urology, The University of Texas M. D. Anderson Cancer Center, Houston, TX, USA W. C. Huang Department of Urology, New York University, New York, NY, USA
had WI, whereas 92 % of open partial nephrectomy patients (n = 953) had CI. The CI group had a lower mean baseline GFR (72 vs. 80 ml/min/1.73 m2), longer median ischemia time (33 vs. 29 min), and larger mean tumor size (3.2 vs. 2.9 cm) with more advanced pathologic stage (T1b-T3: 25 vs. 16 %) (all p values
