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. 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 at 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% 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 LKDs who completed the final pain assessment, 72 (40%) met criteria for chronic postsurgical pain (CPSP), i.e., any donation-related pain on POD56. Study findings have potential implications for LKD education, surgical consent, postdonation care, and outcomes measurement.