Pain expectancy, prevalence, severity, and patterns following donor nephrectomy: Findings from the KDOC Study
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 postopera...
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| Veröffentlicht in: | American journal of transplantation 2020-09, Vol.20 (9), p.2522-2529 |
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| creator | Fleishman, Aaron Khwaja, Khalid Schold, Jesse D. Comer, Carly D. Morrissey, Paul Whiting, James Vella, John Kayler, Liise K. Katz, Daniel Jones, Jody Kaplan, Bruce Pavlakis, Martha Mandelbrot, Didier A. Rodrigue, James R. |
| description | 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.
This prospective, multicenter study to assess pain following living kidney donation reports that many donors experience prolonged postsurgical pain and that predonation history of mood disorder, early severe postoperative pain, and open nephrectomy were associated with higher pain scores. |
| doi_str_mv | 10.1111/ajt.15861 |
| format | Article |
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This prospective, multicenter study to assess pain following living kidney donation reports that many donors experience prolonged postsurgical pain and that predonation history of mood disorder, early severe postoperative pain, and open nephrectomy were associated with higher pain scores.</description><identifier>ISSN: 1600-6135</identifier><identifier>EISSN: 1600-6143</identifier><identifier>DOI: 10.1111/ajt.15861</identifier><identifier>PMID: 32185880</identifier><language>eng</language><publisher>HOBOKEN: Wiley</publisher><subject>anesthesia/pain management ; Blood & organ donations ; Chronic pain ; clinical research/practice ; donors and donation ; donors and donation: donor follow‐up ; donors and donation: living ; Expectancy ; Follow-Up Studies ; Health psychology ; health services and outcomes research ; Humans ; Kidney Transplantation - adverse effects ; kidney transplantation/nephrology ; kidney transplantation:living donor ; Kidney transplants ; Life Sciences & Biomedicine ; Living Donors ; Mood ; Nephrectomy ; Nephrectomy - adverse effects ; Organ donors ; Pain ; Pain, Postoperative - epidemiology ; Pain, Postoperative - etiology ; Postoperative period ; Prevalence ; quality of life (QOL) ; Science & Technology ; Surgery ; Transplantation</subject><ispartof>American journal of transplantation, 2020-09, Vol.20 (9), p.2522-2529</ispartof><rights>2020 The American Society of Transplantation and the American Society of Transplant Surgeons</rights><rights>2020 The American Society of Transplantation and the American Society of Transplant Surgeons.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>true</woscitedreferencessubscribed><woscitedreferencescount>10</woscitedreferencescount><woscitedreferencesoriginalsourcerecordid>wos000525997400001</woscitedreferencesoriginalsourcerecordid><citedby>FETCH-LOGICAL-c4431-4620af27176a031c0b9e4496e35bd1753b0e6b4180438713277d35b4f861b4553</citedby><cites>FETCH-LOGICAL-c4431-4620af27176a031c0b9e4496e35bd1753b0e6b4180438713277d35b4f861b4553</cites><orcidid>0000-0001-5589-4919 ; 0000-0002-3080-6238 ; 0000-0001-7338-8235 ; 0000-0002-6495-0078</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fajt.15861$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fajt.15861$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>230,315,781,785,886,1418,27929,27930,28253,45579,45580</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32185880$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Fleishman, Aaron</creatorcontrib><creatorcontrib>Khwaja, Khalid</creatorcontrib><creatorcontrib>Schold, Jesse D.</creatorcontrib><creatorcontrib>Comer, Carly D.</creatorcontrib><creatorcontrib>Morrissey, Paul</creatorcontrib><creatorcontrib>Whiting, James</creatorcontrib><creatorcontrib>Vella, John</creatorcontrib><creatorcontrib>Kayler, Liise K.</creatorcontrib><creatorcontrib>Katz, Daniel</creatorcontrib><creatorcontrib>Jones, Jody</creatorcontrib><creatorcontrib>Kaplan, Bruce</creatorcontrib><creatorcontrib>Pavlakis, Martha</creatorcontrib><creatorcontrib>Mandelbrot, Didier A.</creatorcontrib><creatorcontrib>Rodrigue, James R.</creatorcontrib><creatorcontrib>KDOC Study Grp</creatorcontrib><creatorcontrib>KDOC Study Group</creatorcontrib><title>Pain expectancy, prevalence, severity, and patterns following donor nephrectomy: Findings from the KDOC Study</title><title>American journal of transplantation</title><addtitle>AM J TRANSPLANT</addtitle><addtitle>Am J Transplant</addtitle><description>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.
This prospective, multicenter study to assess pain following living kidney donation reports that many donors experience prolonged postsurgical pain and that predonation history of mood disorder, early severe postoperative pain, and open nephrectomy were associated with higher pain scores.</description><subject>anesthesia/pain management</subject><subject>Blood & organ donations</subject><subject>Chronic pain</subject><subject>clinical research/practice</subject><subject>donors and donation</subject><subject>donors and donation: donor follow‐up</subject><subject>donors and donation: living</subject><subject>Expectancy</subject><subject>Follow-Up Studies</subject><subject>Health psychology</subject><subject>health services and outcomes research</subject><subject>Humans</subject><subject>Kidney Transplantation - adverse effects</subject><subject>kidney transplantation/nephrology</subject><subject>kidney transplantation:living donor</subject><subject>Kidney transplants</subject><subject>Life Sciences & Biomedicine</subject><subject>Living Donors</subject><subject>Mood</subject><subject>Nephrectomy</subject><subject>Nephrectomy - adverse effects</subject><subject>Organ donors</subject><subject>Pain</subject><subject>Pain, Postoperative - epidemiology</subject><subject>Pain, Postoperative - etiology</subject><subject>Postoperative period</subject><subject>Prevalence</subject><subject>quality of life (QOL)</subject><subject>Science & Technology</subject><subject>Surgery</subject><subject>Transplantation</subject><issn>1600-6135</issn><issn>1600-6143</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>AOWDO</sourceid><sourceid>EIF</sourceid><recordid>eNqNkVtv1DAQhSMEohd44A8gS7yA6LZ27NgOD0hVoNwqFYnybDnJpOtVYqe2s23-PV52WQESEn7xaOabo2OfLHtG8ClJ50yv4ikpJCcPskPCMV5wwujDfU2Lg-wohBXGROQyf5wd0JzIQkp8mA1ftbEI7kdoorbNfIJGD2vdg23gBAVYgzcxdbVt0ahjBG8D6lzfuztjb1DrrPPIwrj0ScAN8xt0YWybRonybkBxCejLu6sKfYtTOz_JHnW6D_B0dx9n3y_eX1cfF5dXHz5V55eLhjFKFoznWHe5IIJrTEmD6xIYKznQom6JKGiNgdeMSMyoFITmQrRpxLr0BTUrCnqcvd3qjlM9QNuAjV73avRm0H5WThv158SapbpxayWYpFxsBF7uBLy7nSBENZjQQN9rC24KKqdCSklyyRP64i905SZv0_NUnuzRkpRcJOrVlmq8C8FDtzdDsNqEqFKI6meIiX3-u_s9-Su1BMgtcAe160JjNmntMYxxkRdlKViqMKlM1NE4W7nJxrT6-v9XE322o00P878tq_PP11vvPwCL3saK</recordid><startdate>202009</startdate><enddate>202009</enddate><creator>Fleishman, Aaron</creator><creator>Khwaja, Khalid</creator><creator>Schold, Jesse D.</creator><creator>Comer, Carly D.</creator><creator>Morrissey, Paul</creator><creator>Whiting, James</creator><creator>Vella, John</creator><creator>Kayler, Liise K.</creator><creator>Katz, Daniel</creator><creator>Jones, Jody</creator><creator>Kaplan, Bruce</creator><creator>Pavlakis, Martha</creator><creator>Mandelbrot, Didier A.</creator><creator>Rodrigue, James R.</creator><general>Wiley</general><general>Elsevier Limited</general><scope>AOWDO</scope><scope>BLEPL</scope><scope>DTL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QP</scope><scope>7T5</scope><scope>7U9</scope><scope>H94</scope><scope>K9.</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0001-5589-4919</orcidid><orcidid>https://orcid.org/0000-0002-3080-6238</orcidid><orcidid>https://orcid.org/0000-0001-7338-8235</orcidid><orcidid>https://orcid.org/0000-0002-6495-0078</orcidid></search><sort><creationdate>202009</creationdate><title>Pain expectancy, prevalence, severity, and patterns following donor nephrectomy: Findings from the KDOC Study</title><author>Fleishman, Aaron ; Khwaja, Khalid ; Schold, Jesse D. ; Comer, Carly D. ; Morrissey, Paul ; Whiting, James ; Vella, John ; Kayler, Liise K. ; Katz, Daniel ; Jones, Jody ; Kaplan, Bruce ; Pavlakis, Martha ; Mandelbrot, Didier A. ; Rodrigue, James R.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4431-4620af27176a031c0b9e4496e35bd1753b0e6b4180438713277d35b4f861b4553</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>anesthesia/pain management</topic><topic>Blood & organ donations</topic><topic>Chronic pain</topic><topic>clinical research/practice</topic><topic>donors and donation</topic><topic>donors and donation: donor follow‐up</topic><topic>donors and donation: living</topic><topic>Expectancy</topic><topic>Follow-Up Studies</topic><topic>Health psychology</topic><topic>health services and outcomes research</topic><topic>Humans</topic><topic>Kidney Transplantation - adverse effects</topic><topic>kidney transplantation/nephrology</topic><topic>kidney transplantation:living donor</topic><topic>Kidney transplants</topic><topic>Life Sciences & Biomedicine</topic><topic>Living Donors</topic><topic>Mood</topic><topic>Nephrectomy</topic><topic>Nephrectomy - adverse effects</topic><topic>Organ donors</topic><topic>Pain</topic><topic>Pain, Postoperative - epidemiology</topic><topic>Pain, Postoperative - etiology</topic><topic>Postoperative period</topic><topic>Prevalence</topic><topic>quality of life (QOL)</topic><topic>Science & Technology</topic><topic>Surgery</topic><topic>Transplantation</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Fleishman, Aaron</creatorcontrib><creatorcontrib>Khwaja, Khalid</creatorcontrib><creatorcontrib>Schold, Jesse D.</creatorcontrib><creatorcontrib>Comer, Carly D.</creatorcontrib><creatorcontrib>Morrissey, Paul</creatorcontrib><creatorcontrib>Whiting, James</creatorcontrib><creatorcontrib>Vella, John</creatorcontrib><creatorcontrib>Kayler, Liise K.</creatorcontrib><creatorcontrib>Katz, Daniel</creatorcontrib><creatorcontrib>Jones, Jody</creatorcontrib><creatorcontrib>Kaplan, Bruce</creatorcontrib><creatorcontrib>Pavlakis, Martha</creatorcontrib><creatorcontrib>Mandelbrot, Didier A.</creatorcontrib><creatorcontrib>Rodrigue, James R.</creatorcontrib><creatorcontrib>KDOC Study Grp</creatorcontrib><creatorcontrib>KDOC Study Group</creatorcontrib><collection>Web of Science - Science Citation Index Expanded - 2020</collection><collection>Web of Science Core Collection</collection><collection>Science Citation Index Expanded</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Immunology Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>American journal of transplantation</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Fleishman, Aaron</au><au>Khwaja, Khalid</au><au>Schold, Jesse D.</au><au>Comer, Carly D.</au><au>Morrissey, Paul</au><au>Whiting, James</au><au>Vella, John</au><au>Kayler, Liise K.</au><au>Katz, Daniel</au><au>Jones, Jody</au><au>Kaplan, Bruce</au><au>Pavlakis, Martha</au><au>Mandelbrot, Didier A.</au><au>Rodrigue, James R.</au><aucorp>KDOC Study Grp</aucorp><aucorp>KDOC Study Group</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Pain expectancy, prevalence, severity, and patterns following donor nephrectomy: Findings from the KDOC Study</atitle><jtitle>American journal of transplantation</jtitle><stitle>AM J TRANSPLANT</stitle><addtitle>Am J Transplant</addtitle><date>2020-09</date><risdate>2020</risdate><volume>20</volume><issue>9</issue><spage>2522</spage><epage>2529</epage><pages>2522-2529</pages><issn>1600-6135</issn><eissn>1600-6143</eissn><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.
This prospective, multicenter study to assess pain following living kidney donation reports that many donors experience prolonged postsurgical pain and that predonation history of mood disorder, early severe postoperative pain, and open nephrectomy were associated with higher pain scores.</abstract><cop>HOBOKEN</cop><pub>Wiley</pub><pmid>32185880</pmid><doi>10.1111/ajt.15861</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0001-5589-4919</orcidid><orcidid>https://orcid.org/0000-0002-3080-6238</orcidid><orcidid>https://orcid.org/0000-0001-7338-8235</orcidid><orcidid>https://orcid.org/0000-0002-6495-0078</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | anesthesia/pain management Blood & organ donations Chronic pain clinical research/practice donors and donation donors and donation: donor follow‐up donors and donation: living Expectancy Follow-Up Studies Health psychology health services and outcomes research Humans Kidney Transplantation - adverse effects kidney transplantation/nephrology kidney transplantation:living donor Kidney transplants Life Sciences & Biomedicine Living Donors Mood Nephrectomy Nephrectomy - adverse effects Organ donors Pain Pain, Postoperative - epidemiology Pain, Postoperative - etiology Postoperative period Prevalence quality of life (QOL) Science & Technology Surgery Transplantation |
| title | Pain expectancy, prevalence, severity, and patterns following donor nephrectomy: Findings from the KDOC Study |
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