Acute and chronic post-surgical pain after living liver donation: Incidence and predictors

dc.contributor.authorHolztman, S.
dc.contributor.authorClarke, Hance
dc.contributor.authorMcCluskey, S.
dc.contributor.authorTurcotte, K.
dc.contributor.authorGrant, David
dc.contributor.authorKatz, Joel
dc.date.accessioned2016-11-16T00:11:22Z
dc.date.available2016-11-16T00:11:22Z
dc.date.issued2014-11
dc.description.abstractDespite its prominence as a concern among potential surgical candidates, there is little information in the literature regarding the short- and long-term pain experience after living liver donation. We undertook a prospective study to examine (1) the nature and incidence of acute and chronic pain after living donor hepatectomy and (2) the factors associated with an increased or decreased risk of adverse pain outcomes. Before donation, a comprehensive assessment of potential predictors of acute and chronic pain outcomes was conducted; this included donors’ pain expectations, psychosocial factors, medical histories, and demographic factors. Detailed data regarding pain outcomes were collected postoperatively (days 1 and 2) and again during 6- and 12-month follow-up telephone interviews. Sixty-five adults (32 females and 33 males) scheduled for donor hepatectomy participated. Substantial proportions of the donors reported a moderate-to-severe level of pain intensity (4 on a 0-10 scale) at rest and after movement on day 1 (42% and 74%, respectively) and day 2 (33% and 32%, respectively). Persistent postsurgical pain was reported by 31% of the donors at the 6-month follow-up and by 27% of the donors at the 12-month follow-up. Generally, this pain was mild, and pain-related life interference was minimal. Female sex, a younger age, and several predonation measures of pain-related anxiety were associated with a significantly greater risk of developing persistent postsurgical pain. In conclusion, this study has identified a subset of patients who experience persistent pain after living liver donation. Additional prospective research using larger samples of liver donors is needed to replicate this work, to obtain a more detailed account of the acute and long-term pain experience, and to determine whether targeted interventions can minimize the frequency and severity of chronic pain.en_US
dc.description.sponsorshipHance A. Clarke is supported by a merit award from the Department of Anesthesia at the University of Toronto and by the Strategic Training for Advanced Genetic Epidemiology program at the Canadian Institutes of Health Research. Joel Katz is supported as a Canadian Institutes of Health Research Canada Research Chair in Health Psychology at York University.
dc.identifier.citationHoltzman, S., Clarke, H., McCluskey, S., Turcotte, K., Grant, D., & Katz, J. (2014). Acute and chronic post-surgical pain after living liver donation: Incidence and predictors. Liver Transplantation, Nov, 20 (11), 1336-1346. doi: 10.1002/lt.23949
dc.identifier.issnISSN: 1527-6465, ESSN: 1527-6473
dc.identifier.urihttp://hdl.handle.net/10315/32579
dc.language.isoen_USen_US
dc.publisherWileyen_US
dc.rightsThis is the accepted version of the following article: Holtzman, S., Clarke, H., McCluskey, S., Turcotte, K., Grant, D., & Katz, J. (2014). Acute and chronic post-surgical pain after living liver donation: Incidence and predictors. Liver Transplantation, Nov, 20 (11), 1336-1346. doi: 10.1002/lt.23949 which has been published in final form at file: http://onlinelibrary.wiley.com/doi/10.1002/lt.23949/epdfen_US
dc.rights.articlehttp://onlinelibrary.wiley.com/doi/10.1002/lt.23949/full
dc.rights.journalhttp://aasldpubs.onlinelibrary.wiley.com/hub/journal/10.1002/(ISSN)1527-6473/en_US
dc.rights.publisherhttp://onlinelibrary.wiley.com/en_US
dc.titleAcute and chronic post-surgical pain after living liver donation: Incidence and predictors
dc.typeArticleen_US

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