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Home-based LIver FrailTy Intervention (LIFT) in Transplant Candidates: A Feasibility Study
Avesh J Thuluvath1,2, Praneet Polineni1, Sheila Morrissey3
1Northwestern University Transplant Outcomes Research Collaborative, Comprehensive Transplant Center, Feinberg School of Medicine, Northwestern University, Chicago, IL.
Transplantation
|March 25, 2025
Summary
A home-based frailty intervention improved frailty in liver transplant candidates. This pilot study shows feasibility, with significant frailty improvement compared to a control group.
Area of Science:
- Hepatology
- Geriatrics
- Rehabilitation Medicine
Background:
- Frailty is common in end-stage liver disease (ESLD) patients.
- Frailty predicts poor outcomes, including mortality, in liver transplant candidates.
- Effective interventions to reverse frailty in ESLD are limited.
Purpose of the Study:
- To test the feasibility of a novel home-based frailty intervention for liver transplant candidates.
- To assess the intervention's impact on frailty metrics.
Main Methods:
- A pilot study involving 54 liver transplant candidates with cirrhosis.
- Intervention included home exercise equipment, a smartphone app, and remote assessments.
- Utilized the Liver Frailty Index (LFI) to measure frailty.
Main Results:
- The intervention group showed a clinically meaningful improvement in LFI (mean change -0.11, P=0.05).
- A retrospective control group did not demonstrate significant LFI changes (P=0.57).
- Adherence to exercise was 56%, but declined over time, highlighting engagement challenges.
Conclusions:
- A home-based frailty intervention is feasible for liver transplant candidates.
- The intervention demonstrated a significant improvement in frailty.
- Further research, including RCTs, is needed to confirm efficacy and clinical impact.
