Ricerc@Sapienza

Introduction
The aetiology of pain after laparoscopic donor nephrectomy remains unclear. Given the
proximity of the left kidney to the tail of the pancreas, we aimed to assess whether mobilisation
and retrieval of the left kidney might inflame the pancreas, leading to pain and
hyperamylasaemia in the post-operative period.
Patient and methods
In the present study, 16 consecutive live kidney donors were analysed in the same three months
period. Amylase levels were measured on days 1 and 2. For each 24-hour period postoperatively
analgesia consumption was recorded, as well as pain scores at rest on a visual
analogue scale (VAS).
Results
Three out of 16 donors presented hyperamylasemia. A multiple regression analysis found
levobupivacaine dose, propofol dose, transversus abdominis plane block and day 1 amylase did
not significantly predict pain scores. Interestingly, body mass index significantly correlated
with increased pain scores (p = 0.041). Also, increasing CO2 insufflation pressure and use of
local anaesthetic infusion catheters predicted a decreased deep pain score (p = 0.036 and p =
0.037).
Conclusion
There was no correlation of amylase levels and pain scores. Pancreatitis is a rare complication
of nephrectomy and no overt cases were seen in the case of donor nephrectomy.