Chronic Pain Following Pediatric Liver Transplantation: A Single‐Center Prospective Observational Study

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BACKGROUND: Chronic postsurgical pain (CPSP) has been reported in approximately 20% of children across all surgery types 12 months after surgery and is associated with poorer functional outcomes and health-related quality of life. However, data on pediatric liver transplantation recipients are lacking. METHODS: Among all patients who visited our organ transplantation center outpatient clinic between April 2023 and January 2024, those who met the following criteria were included: (1) had undergone liver transplantation under 18 years of age, (2) older than 6 years on the day of their visit, and (3) more than three months had passed since their last liver transplantation. Prevalence of pain at the surgical site, characteristics of pain, and interference with daily functioning were asked. CPSP was defined as pain persisting over three months post-surgery with intensity rated ≥ 3 on a 10-point visual analog scale (VAS). RESULTS: A total of 242 patients returned valid responses; 136 (56.2%) were female. Median age at transplantation was 24 months (IQR 9-86) and 12 years (IQR 9-15) at questionnaire distribution. Thirty-three (13.6%) patients reported pain, of which 12 (5.0%) presented CPSP. Among patients with CPSP, the median value of 'maximum VAS within the past month' was 4.4. Two patients reported interference with daily activities. Multivariate analysis revealed female sex as the only factor independently associated with postsurgical pain (OR = 2.91 [95% CI, 1.24-6.83]). CONCLUSIONS: Overall prevalence of chronic pain was low; potential underreporting due to cultural backgrounds may be present. However, some patients reported pain persisting years after transplantation, indicating the need for long-term follow-up.

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