The Effect of Psychiatric History on Pain and Related Outcomes Among Living Kidney Donors. (June 2021)

• Record Type: Journal Article
• Authors: Fox, Kristen R.; Gulin, Shaina L.; Bruschwein, Heather M.; Rose, Terra; Burker, Eileen J.; Kozlowski, Tomasz; Loiselle, Marci M.
• Is Part Of: Progress in transplantation. Volume 31:Number 2(2021)
• Page Start: 108
• Page End: 116
• Publication Date: 2021-06
• Subjects: living kidney donation -- opioid use -- pain -- psychiatric history -- psychological evaluation; Transplantation of organs, tissues, etc -- Periodicals; Transplantation; Organ Procurement; Tissue Donors; Transplantation of organs, tissues, etc; Electronic journals; Periodicals; Periodicals; 362.1783
• DOI: 10.1177/15269248211002809
• Languages: English
• ISSNs: 1526-9248

Abstract

Introduction: Living donor transplantation of kidneys accounts for one quarter of transplants performed in the United States. Careful screening of psychiatric history is a standard part of the donor evaluation. Little is known about the impact of psychiatric history on post-donation course and pain experience. Research Question: This study investigated whether psychiatric history was associated with pain and related outcomes among living kidney donors. Design: A retrospective medical record review was conducted of 75 living kidney donors who underwent laparoscopic donor nephrectomy. All donor candidates completed a psychological evaluation and were approved for donation by a multidisciplinary committee. History of psychiatric diagnosis and psychiatric medication use were obtained from donors' psychological evaluation reports. Data on pain and related outcomes (ie, history of prescribed pain medication, post-donation pain, opioid use, length of hospital stay, post-donation emergency department visits), as well as demographic and donation-related characteristics were also abstracted from medical records. Results: Psychiatric history, including current or historical psychiatric diagnosis or psychiatric medication use, in living kidney donors who were evaluated and approved for donation by a transplant psychologist was not associated with greater perceived pain, greater use of opioid pain medication in the post-operative period, longer hospital stays, or more frequent post-donation emergency department visits. Discussion: The findings demonstrate that carefully screened donors with a psychiatric history have comparable pain-related outcomes as donors without a psychiatric history. This study highlights the importance of the pre-donation psychological evaluation in promoting positive postdonation outcomes through careful selection of donor candidates.