*Purpose: This study evaluated the outcomes between living kidney donors who received a multimodal analgesic regimen compared to a historical cohort that did not.

*Methods: Hartford Hospital implemented a multimodal analgesic regimen for living kidney donors in March 2019. This regimen consists of pharmacist-led pre-procedure pain management education, a transverse abdominis plane (TAP) block with bupivacaine and dexamethasone, scheduled acetaminophen and gabapentin, and as-needed opioids. This was a single-center retrospective chart review of patients who underwent laparoscopic living donor nephrectomy from 8/16/2016-7/1/2020. Patients who received the multimodal regimen comprised the multimodal (MM) group, and those who did not comprised the historical group.

*Results: The baseline characteristics are described in Table 1. 68 patients comprised the historical group and 44 comprised the MM group. The MM group had a significantly shorter length of stay (LOS) (days, mean±SD: 1.8±0.7 vs 2.6±0.8; p<0.001). More patients were discharged on postoperative day (POD) 1 in the MM group (38.6% vs 1.5%; p<0.001). The total morphine milligram equivalents (MME) donors received while inpatient was significantly less in the MM group vs the historical group on POD 0-2 (Figure 1). The outpatient MME prescribed through POD 60 was also significantly less in the MM group (median [IQR]; 180 [150-188] vs 225 [150-300]; p<0.001). The mean patient-reported pain score (PRPS) was significantly lower in the MM group vs the historical group on POD 0, 1, and 2 (Figure 1). The maximum PRPS was significantly lower on POD 0 in the MM group (mean±SD: 7±2 vs 8±1; p=0.02). There was no significant difference in renal function prior to donation through POD 180. There were no significant differences in readmission (4.5% vs 4.4%; p=0.97), surgical site infection (2.3% vs 4.4%; p=0.55), or postoperative ileus (0% vs 7.4%; p=0.07), between the MM and historic groups, respectively.

*Conclusions: In conclusion, this multimodal analgesic regimen resulted in a significantly shorter LOS, significantly lower PRPS, and significantly lower opioid requirements following living kidney donation.

« Back to 2021 American Transplant Congress