title: Chronic pain among liver transplant candidates.
abstract: BACKGROUND
  Little systematic research has been conducted to understand pain among persons with end-stage liver disease, especially among liver transplant candidates. Appropriate pain assessment and management are important areas of consideration as treatment options are limited.
  
  
  OBJECTIVE
  To describe the nature of chronic pain in patients with end-stage liver disease, the extent to which pain affects daily level of functioning, and the variety and effectiveness of current treatments.
  
  
  METHODS
  Retrospective chart review.
  
  
  METHODS
  Academic medical center in the Southeastern United States.
  
  
  METHODS
  Data were collected from 108 consecutive adult liver transplant candidates.
  
  
  RESULTS
  Most (77%) reported having experienced moderate levels of bodily pain within the past 24 hours. Patients with only alcoholic cirrhosis reported less pain than patients with cirrhosis due to other causes (alcoholism and hepatitis C, nonalcoholic steatohepatitis, only hepatitis C). Pain interfered significantly across all 10 functional domains assessed. Although 90% reported being prescribed a variety of analgesic agents (most commonly short-acting opioids), patients reported experiencing only 33% pain relief.
  
  
  CONCLUSIONS
  Pain is a significant problem among liver transplant candidates, and current pain treatments are perceived to be relatively ineffective. Increased understanding is needed to safely and effectively evaluate and treat such medically complicated patients.
authors.affiliation: Medical University of South Carolina, Charleston, SC, USA. madana@musc.edu
authors.forename: Alok
authors.initials: A
authors.lastname: Madan
authors.forename: Kelly S
authors.initials: KS
authors.lastname: Barth
authors.forename: Wendy E
authors.initials: WE
authors.lastname: Balliet
authors.forename: Melba A
authors.initials: MA
authors.lastname: Hernandez-Tejada
authors.forename: Jeffrey J
authors.initials: JJ
authors.lastname: Borckardt
authors.forename: Robert
authors.initials: R
authors.lastname: Malcolm
authors.forename: Ira
authors.initials: I
authors.lastname: Willner
authors.forename: David
authors.initials: D
authors.lastname: Koch
authors.forename: Adrian
authors.initials: A
authors.lastname: Reuben
mesh_terms: D000203:Activities of Daily Living; D000700:Analgesics / Q000627:therapeutic use*; D000704:Analysis of Variance; D059350:Chronic Pain / Q000209:etiology* / Q000517:prevention & control*; D058625:End Stage Liver Disease / Q000150:complications* / Q000601:surgery*; D005260:Female; D006801:Humans; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D059408:Pain Management; D010147:Pain Measurement; D012189:Retrospective Studies
chemical_list: D000700:Analgesics