Live donation of a kidney transplant carries various risks
One concern is opioid exposure
The use of narcotic pain medications in conjunction with general anesthesia can delay a donor’s return to normal daily function... and may even lead to addiction
One option to avoid these issues is non-opioid analgesics
But it’s not clear whether such alternatives jeopardize patient care or decrease patient satisfaction
A new Enhanced Recovery After Surgery (ERAS) pathway may help control postoperative pain without narcotics
The protocol uses preoperative pregabalin to desensitize nerves, followed by the NSAID ketorolac during and after surgery
A randomized clinical trial involving 62 patients undergoing nephrectomy for live donor kidney transplantation showed promising results for the approach
The ERAS pathway significantly reduced length of hospital stay by 10% compared to the standard of care plus placebo
Morphine dose equivalents were also significantly reduced by 40% in the study group
Importantly, these effects were achieved without increasing the risk of complications
Opioid addiction, patient satisfaction, and cost of care are important concerns in surgery
The ERAS pathway provides a hopeful alternative to address these issues for live kidney donors
Campsen J. et al. Prospective, double blind, randomized clinical trial comparing an ERAS pathway with Ketorolac and Pregabalin versus standard of care plus placebo during live donor nephrectomy for kidney transplant. (2019) Amer J Transplant