Robotic Partial Nephrectomy with Adjunctive Ultra-Thick Amniotic Membrane Allograft

Background: /Objectives: To assess the clinical outcomes following robotic partial nephrectomy with adjunctive cryopreserved, ultra-thick amniotic membrane (AM), which is known to have anti-inflammatory and anti-scarring properties and may help reduce inflammatory and ischemic insult, prevent parenchymal and capsular post-surgical scar formation, and help preserve kidney function. Methods: A retrospective review was performed on high-risk patients that underwent robotic partial nephrectomy followed by application of cryopreserved ultra-thick AM between August 2021 and August 2024. Baseline characteristics, operative times, creatinine levels, and glomerular filtration rate (GFR) were assessed. Results: Forty patients (21 female; 19 male) with an average age of 67.9 ± 9.8 years were included in the analysis. The mean GFR and creatinine levels at baseline were 73.4 ± 20.1 ml/min and 1.03 ± 0.51 mg/dl, respectively. Surgery was uneventful in all cases, with an average warm ischemia time of 11.9 ± 2.0 min. When compared to baseline, the average change in GFR and creatinine was -6.6 ± 11.3 ml/min and 0.086 ± 0.163 mg/dl at 1 month, -9.4 ± 13.3 ml/min and 0.183 ± 0.263 mg/dl at 6 months, -3.9 ± 12.1 ml/min and 0.116 ± 0.251 mg/dl at 12 months, -5.1 ± 17.8 ml/min and 0.094 ± 0.220 mg/dl at 24 months, and -4.0 ± 11.2 ml/min and 0.081 ± 0.130 mg/dl at 36 months, respectively. No complications attributable to AM were observed. Conclusions: Robotic partial nephrectomy with adjunctive cryopreserved ultra-thick AM is safe and may help improve clinical outcomes in challenging cases.