Exercise Training for Liver Transplant Candidates

Bandar Al-Judaibi; Ibrahim Alqalami; Michael Sey; Karim Qumosani; Nancy Howes; Lynne Sinclair; Natasha Chandok; Anas Hussam Eddin; Roberto Hernandez-Alejandro; Paul Marotta; Anouar Teriaky

doi:10.1016/j.transproceed.2019.08.045

Exercise Training for Liver Transplant Candidates

Transplant Proc. 2019 Dec;51(10):3330-3337. doi: 10.1016/j.transproceed.2019.08.045. Epub 2019 Nov 13.

Affiliations

¹ Department of Medicine, Division of Gastroenterology, Western University and London Health Sciences Centre, London, Ontario, Canada; Multi-Organ Transplant Program, Western University and London Health Sciences Centre, London, Ontario, Canada; Division of Transplantation, University of Rochester, Rochester, NY, USA. Electronic address: bandaraljudaibi@gmail.com.
² Department of Medicine, Division of Gastroenterology, Western University and London Health Sciences Centre, London, Ontario, Canada.
³ Department of Medicine, Division of Gastroenterology, Western University and London Health Sciences Centre, London, Ontario, Canada; Multi-Organ Transplant Program, Western University and London Health Sciences Centre, London, Ontario, Canada.
⁴ Multi-Organ Transplant Program, Western University and London Health Sciences Centre, London, Ontario, Canada.
⁵ Osler Hepatitis Centre, Brampton Civic Hospital, Brampton, Ontario, Canada.
⁶ Division of Transplantation, University of Rochester, Rochester, NY, USA.

PMID: 31732200
DOI: 10.1016/j.transproceed.2019.08.045

Abstract

Background and aims: Frailty is associated with increased morbidity and mortality, and this is tightly linked to liver decompensation and increased complication rates among liver transplant (LT) candidates. The aim of the study was to evaluate the efficacy of a structured in- and outpatient exercise training program for cirrhotic patients who were referred for liver transplant evaluation.

Methods: We retrospectively reviewed 458 consecutive LT patients. There were 200 patients who underwent LT prior to the implementation of an exercise training program (non-ETP) and 258 LT patients who underwent a comprehensive exercise training program (ETP). Baseline characteristics, readmission rate, and length of hospital stay (LOS) were analyzed and compared between the 2 groups.

Results: The ETP group were more likely to have diabetes mellitus and coronary artery disease. However, there was no significant difference in the postoperative complication rates between the 2 groups except for more infections in the ETP group compared to the non-ETP group. There was a trend toward lower 90-day readmission rate in the ETP group (17.9% vs 20%) and shorter LOS (14 vs 17 days).

Conclusion: There was a trend toward reduced 90-day readmission and shorter length of stay after implementation of an exercise training program.

Publication types

Evaluation Study

MeSH terms

Aged
Exercise Therapy / methods
Exercise Therapy / statistics & numerical data*
Female
Fibrosis / therapy*
Humans
Length of Stay / statistics & numerical data
Liver Transplantation / adverse effects
Liver Transplantation / rehabilitation*
Liver Transplantation / statistics & numerical data
Male
Middle Aged
Patient Readmission / statistics & numerical data
Postoperative Complications / epidemiology
Postoperative Complications / etiology
Preoperative Period
Retrospective Studies
Treatment Outcome