Pain expectancy, prevalence, severity, and patterns following donor nephrectomy: Findings from the KDOC Study.

anesthesia/pain management clinical research/practice donors and donation donors and donation: donor follow-up donors and donation: living health services and outcomes research kidney transplantation/nephrology kidney transplantation:living donor quality of life (QOL)

Journal

American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons
ISSN: 1600-6143
Titre abrégé: Am J Transplant
Pays: United States
ID NLM: 100968638

Informations de publication

Date de publication:
09 2020
Historique:
received: 22 11 2019
revised: 14 02 2020
accepted: 03 03 2020
pubmed: 19 3 2020
medline: 22 6 2021
entrez: 19 3 2020
Statut: ppublish

Résumé

Postoperative pain is an outcome of importance to potential living kidney donors (LKDs). We prospectively characterized the prevalence, severity, and patterns of acute or chronic postoperative pain in 193 LKDs at six transplant programs. Three pain measurements were obtained from donors on postoperative Day (POD) 1, 3, 7, 14, 21, 28, 35, 41, 49, and 56. The median pain rating total was highest on POD1 and declined from each assessment to the next until reaching a median pain-free score of 0 on POD49. In generalized linear mixed-model analysis, the mean pain score decreased at each pain assessment compared to the POD3 assessment. Pre-donation history of mood disorder (adjusted ratio of means [95% confidence interval (CI)]: 1.40 [0.99, 1.98]), reporting "severe" on any POD1 pain descriptors (adjusted ratio of means [95% CI]: 1.47 [1.12, 1.93]) and open nephrectomy (adjusted ratio of means [95% CI]: 2.61 [1.03, 6.62]) were associated with higher pain scores across time. Of the 179 LKDs who completed the final pain assessment, 74 (41%) met criteria for chronic postsurgical pain (CPSP), that is, any donation-related pain on POD56. Study findings have potential implications for LKD education, surgical consent, postdonation care, and outcome measurements.

Identifiants

pubmed: 32185880
doi: 10.1111/ajt.15861
pmc: PMC7483675
mid: NIHMS1579186
pii: S1600-6135(22)22569-6
doi:

Types de publication

Journal Article Research Support, N.I.H., Extramural

Langues

eng

Sous-ensembles de citation

IM

Pagination

2522-2529

Subventions

Organisme : NIDDK NIH HHS
ID : R01 DK085185
Pays : United States

Informations de copyright

© 2020 The American Society of Transplantation and the American Society of Transplant Surgeons.

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Auteurs

Aaron Fleishman (A)

The Transplant Institute, Beth Israel Deaconess Medical Center, Boston, MA, USA.
Harvard Medical School, Boston, MA, USA.

Khalid Khwaja (K)

The Transplant Institute, Beth Israel Deaconess Medical Center, Boston, MA, USA.
Harvard Medical School, Boston, MA, USA.

Jesse D Schold (JD)

Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH, USA.

Carly D Comer (CD)

The Transplant Institute, Beth Israel Deaconess Medical Center, Boston, MA, USA.

Paul Morrissey (P)

Transplant Center, Rhode Island Hospital, Providence, RI, USA.

James Whiting (J)

Maine Transplant Center, Maine Medical Center, Portland, ME, USA.

John Vella (J)

Maine Transplant Center, Maine Medical Center, Portland, ME, USA.

Liise K Kayler (LK)

Montefiore Einstein Center for Transplantation, Bronx, NY, USA.
Regional Center of Excellence for Transplantation & Kidney Care, Erie County Medical Center, University of Buffalo, Buffalo, NY, USA.

Daniel Katz (D)

Organ Transplantation Program, University of Iowa Hospitals and Clinics, Iowa City, IA, USA.

Jody Jones (J)

Organ Transplantation Program, University of Iowa Hospitals and Clinics, Iowa City, IA, USA.

Bruce Kaplan (B)

Baylor Scott and White Health, Temple, TX, USA.

Martha Pavlakis (M)

The Transplant Institute, Beth Israel Deaconess Medical Center, Boston, MA, USA.
Harvard Medical School, Boston, MA, USA.

Didier A Mandelbrot (DA)

Department of Medicine, University of Wisconsin, Madison, WI, USA.

James R Rodrigue (JR)

The Transplant Institute, Beth Israel Deaconess Medical Center, Boston, MA, USA.
Harvard Medical School, Boston, MA, USA.

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Classifications MeSH