Background. Ketorolac is a nonsteroidal anti-inflammatory drug used for postoperative pain management. The purpose of this study is to assess the impact of ketorolac after donor nephrectomy.Material and Methods. We retrospectively reviewed all laparoscopic or robotic donor nephrectomy from April 2008 to January 2015, and enrolled 211 patients. 126 patients received ketorolac intraoperatively and/or postoperatively within 24 hours after nephrectomy, and 85 patients without ketorolac. The pain scores immediately and 24 hours after nephrectomy, length of hospital stay, and reduction of glomerular filtration rate (GFR)at 1 day, 14 days, and 6 monthsafter nephrectomy were compared between the patients with and without ketorolac. Results. Length of hospital stay was significantly shorter in the ketorolac group compared with non-ketorolac group (2.9 vs 3.3 days). Despite no difference in the pain scores immediately after surgery, pain scores at 24 hours were significantly lower in the ketorolac group (3.0 vs 4.5). Although reduction of GFR on day 1 was significantly larger in the ketorolac group, there were no differences on day 14 and 6 months . When patients were classified with the usage doses, reduction of GFR at 6 months after nephrectomy was larger in the total dose ≥ 75mg group, compared with the non-ketorolac group and total dose < 75mg group (non-ketorolac 33% vs total dose < 75mg 36% vs total dose ≥ 75mg 41%, P= 0.07) . Conclusion. Ketorolac showed significant impact in shortening hospital stay and pain control after nephrectomy. However, using dose higher than 75mg might impair renal function in the long term.

CITATION INFORMATION: Takahashi K, Putchakayala K, Malinzak L, Denny J, Abouljoud M, Kim D. Is Ketorolac Really Safe for Donor Nephrectomy? Am J Transplant. 2016;16 (suppl 3).

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