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

Aaron Fleishman; Khalid Khwaja; Jesse D. Schold; Carly D. Comer; Paul Morrissey; James Whiting; John Vella; Liise K. Kayler; Daniel Katz; Jody Jones; Bruce Kaplan; Martha Pavlakis; Didier A. Mandelbrot; James R. Rodrigue; Kidney Donor Outcomes Cohort (KDOC) Study Group

doi:10.1111/ajt.15861

Back

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

Journal article

Open access

Peer reviewed

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

Aaron Fleishman, Khalid Khwaja, Jesse D. Schold, Carly D. Comer, Paul Morrissey, James Whiting, John Vella, Liise K. Kayler, Daniel Katz, Jody Jones, …

American journal of transplantation, Vol.20(9), pp.2522-2529

09/01/2020

DOI: 10.1111/ajt.15861

PMCID: PMC7483675

PMID: 32185880

Files and links (1)

url

https://doi.org/10.1111/ajt.15861View

Published (Version of record) Open Access

Abstract

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.

Surgery

Life Sciences & Biomedicine

Science & Technology

Transplantation

Details

Title: Subtitle: Pain expectancy, prevalence, severity, and patterns following donor nephrectomy: Findings from the KDOC Study
Creators: Aaron Fleishman - Harvard University
Khalid Khwaja - Harvard University
Jesse D. Schold - Cleveland Clinic
Carly D. Comer - Beth Israel Deaconess Medical Center
Paul Morrissey - Rhode Island Hospital
James Whiting - Maine Medical Center
John Vella - Maine Medical Center
Liise K. Kayler - Erie County Medical Center
Daniel Katz - University of Iowa Hospitals and Clinics
Jody Jones - University of Iowa Hospitals and Clinics
Bruce Kaplan - Baylor Medical Center at Garland
Martha Pavlakis - Harvard University
Didier A. Mandelbrot - University of Wisconsin–Madison
James R. Rodrigue - Harvard University
Kidney Donor Outcomes Cohort (KDOC) Study Group
Resource Type: Journal article
Publication Details: American journal of transplantation, Vol.20(9), pp.2522-2529
DOI: 10.1111/ajt.15861
PMID: 32185880
PMCID: PMC7483675
NLM abbreviation: Am J Transplant
ISSN: 1600-6135
eISSN: 1600-6143
Publisher: Wiley
Number of pages: 8
Grant note: R01DK085185 / National Institute of Diabetes and Digestive and Kidney Diseases; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute of Diabetes & Digestive & Kidney Diseases (NIDDK)
Language: English
Date published: 09/01/2020
Academic Unit: Psychological and Brain Sciences; Surgery
Record Identifier: 9984321865102771

Metrics

18 Record Views

18 Times Cited - Web of Science