Chronic Pain One to Five Years after Heart Transplantation

PURPOSE: We know that pain has far-reaching detrimental effects across various life-domains and also affects health related quality of life after solid organ transplantation. However, the extent to which heart recipients experience chronic bodily pain in the years after heart transplantation is a neglected field. Pain is reported to be a major problem after other types of solid organ transplantation. Neither the prevalence nor consequences of chronic pain after heart transplantation have been fully explored or understood. Therefore, the aim was to present a multidimensional assessment of self-reported pain one to five years after heart transplantation and its relationship with transplant specific well-being. METHODS: This nationwide, cross-sectional cohort study is part of the Self-management after thoracic transplantation study. A total of 79 heart recipients, who were due for their annual follow-up at one (n=28), two (n=17), three (n=11), four (n=17) and five years (n=5) after heart transplantation were included. We used three instruments; the Pain-O-Meter (POM), which provides information about pain intensity, sensation, location and duration and the Organ Transplant Symptom and Wellbeing Instrument (OTSWI) and the Psychological General Wellbeing Instrument. RESULTS: The overall prevalence of pain was 57% after 1 year, 76 % after 2 years, 73 % after 3 years, 35 % after 4 years and 50 % after 5 years. Women experienced higher pain intensity than men. The three most common pain locations were feet, back and legs. Heart recipients with pain reported lower transplant specific and psychological well-being as well as higher symptom distress from other symptoms than pain. Those who was back to work reported less pain than those not working. Heart recipients with high general fatigue reported more pain than those less fatigued and there was a relationship between general fatigue, physical fatigue, reduced activity and total pain intensity score. The more fatigue the more pain. CONCLUSION: Chronic bodily pain up to 5 years after heart transplantation reduces perceived well-being. Heart recipients with pain report higher symptom distress than those without pain. Screening for pain, especially among female heart recipients should be mandatory