Cold Versus Warm Ischemia Robot-Assisted Partial Nephrectomy: Comparison of Functional Outcomes in Propensity-Score Matched “At Risk” Patients

Abstract Objectives: To compare functional outcomes of warm ischemiaRPN (wRPN) to cold ischemia RPN (cRPN) in “at risk” patients. Materials and Methods: Retrospective review of institutional database queried for all patients who underwent cRPN/wRPN (January 2007–December 2016). For the study purpose, patients with solitary kidney and/or history of partial nephrectomy and/or multiple tumors and/or preoperative estimated Glomerular Filtration Rate (eGFR) <60 mL/minute were extracted. To reduce inherent biases, groups were matched on key variables related to renal function through a greedy matching algorithm with no replacement. Renal functional outcomes were evaluated by eGFR drops at 1–3 days and at 1, 3, 6, and 12 months postoperatively. A linear mixed effects model was used to assess eGFR at each follow-up who received either cRPN or wRPN. Follow-up was treated as a factor variable to account for nonlinear time trends. Contrast analysiswas used to compare cRPN vs wRPN groups at each follow-up, using Si...