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A Rat Lung Transplantation Model of Warm Ischemia/Reperfusion Injury: Optimizations to Improve Outcomes
Published on: October 28, 2021
An innovative prehabilitation approach for lung transplant candidates
Karen P Barr1, George Tankosich2, Bryan Willey3
1Department of Physical Medicine and Rehabilitation, University of Pittsburgh/UPMC, Pittsburgh, Pennsylvania, USA.
Background:
Frailty is a risk factor for poor outcomes in lung transplantation. Identifying the causes of frailty and addressing reversible risk factors that contribute to poor outcomes in this population is complex.
Objective:
To describe the results of frailty measures associated with poor outcomes and the prehabilitation plan prescribed for patients at their initial assessment for lung transplantation at our institution. We describe how a prehabilitation approach to improve function and mitigate risk factors can be incorporated into lung transplant selection committee recommendations.
Methods:
Data were analyzed from 186 patients seen in an outpatient physical medicine and rehabilitation (PM&R) clinic as part of their initial assessment for lung transplantation and their lung selection committee recommendations.
Results:
All 186 patients who initiated evaluation for lung transplant were evaluated by PM&R during their transplant initial evaluation period. Low objective and self-reported physical function were present in the majority of patients. All patients received a multimodal prehabilitation plan to address these reversible risk factors. Prehabilitation recommendations were integrated into their lung selection committee recommendations.
Conclusion:
A comprehensive physiatric assessment for the purpose of identifying reversible risk factors for poor outcomes such as frailty and prescribing interventions to improve function is a feasible addition to the lung transplant evaluation process. This patient population has high prehabilitation needs.
