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

American Journal of Transplantation Apr 17, 2020

Fleishman A, Khwaja K, Schold JD, et al. - Since postoperative pain represents an outcome of significance to potential living kidney donors (LKDs), researchers focused on prospectively defining the prevalence, severity, as well as the patterns of acute or chronic postoperative pain among 193 LKDs at six transplant programs. On postoperative Day (POD) 1, 3, 7, 14, 21, 28, 35, 41, 49, and 56, three pain measurements were taken from donors. On POD1, the observed median pain rating total was identified to be the highest, and reduced from each evaluation to the next until reaching a median pain‐free score of 0 on POD49. A reduction in the mean pain score was evident at each pain evaluation vs the POD3 assessment in generalized linear mixed‐model analysis. Pre-donation history of mood disorder, reporting “severe” on any POD1 pain descriptors and open nephrectomy were found to be related to higher pain scores across time. Among 179 LKDs who finished the final pain evaluation, 74 (41%) satisfied criteria for chronic postsurgical pain, that is, any donation‐associated pain on POD56. The potential implications of these observations for LKD education, surgical consent, postdonation care, and outcome measurements was suggested.

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