Exercise Training for Liver Transplant Candidates.

Area of Science:

• Hepatology
• Transplantation Medicine
• Geriatric Medicine

Background:

• Frailty is a significant predictor of poor outcomes in liver transplant candidates, including increased morbidity, mortality, and complications.
• Liver decompensation in cirrhotic patients is closely linked to frailty and adverse events.
• Pre-transplant frailty assessment is crucial for optimizing patient selection and management.

Purpose of the Study:

• To evaluate the effectiveness of a structured exercise training program (ETP) for patients with cirrhosis undergoing liver transplant evaluation.
• To compare outcomes between liver transplant recipients who participated in an ETP and those who did not.
• To assess the impact of ETP on postoperative complications, readmission rates, and length of hospital stay.

Main Methods:

• Retrospective review of 458 consecutive liver transplant (LT) patients.
• Comparison of 200 LT patients (non-ETP group) with 258 LT patients (ETP group) who underwent a comprehensive exercise training program.
• Analysis of baseline characteristics, 90-day readmission rates, and length of hospital stay (LOS) between the ETP and non-ETP cohorts.

Main Results:

• The ETP group had a higher prevalence of diabetes mellitus and coronary artery disease.
• No significant difference in overall postoperative complication rates, although the ETP group experienced more infections.
• A trend towards a lower 90-day readmission rate (17.9% vs. 20%) and shorter LOS (14 vs. 17 days) in the ETP group.

Conclusions:

• Implementation of a structured exercise training program showed a trend towards reduced 90-day readmission rates after liver transplantation.
• The exercise training program was associated with a trend towards a shorter length of hospital stay post-transplant.
• Further prospective studies are warranted to confirm the benefits of pre-transplant exercise interventions in liver transplant recipients.