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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.
Summary
Frailty negatively impacts lung transplant outcomes. A prehabilitation program, guided by physiatric assessment, effectively addresses reversible risk factors, improving patient function and selection recommendations.
Area of Science:
- Pulmonology
- Rehabilitation Medicine
- Transplant Surgery
Background:
- Frailty is a significant predictor of adverse outcomes in lung transplantation.
- Identifying and managing reversible contributors to frailty is crucial for this patient cohort.
Purpose of the Study:
- To report on frailty assessments and prehabilitation strategies for lung transplant candidates.
- To integrate prehabilitation into lung transplant selection committee recommendations.
Main Methods:
- Analysis of data from 186 patients undergoing initial lung transplant evaluation.
- Assessment included outpatient physical medicine and rehabilitation (PM&R) clinic visits.
Main Results:
- All evaluated patients demonstrated low physical function (objective and self-reported).
- Multimodal prehabilitation plans were prescribed to mitigate identified risk factors.
- Prehabilitation recommendations were incorporated into lung transplant selection decisions.
Conclusions:
- Physiatric assessment effectively identifies reversible risk factors like frailty in lung transplant candidates.
- Prehabilitation interventions are feasible and beneficial within the lung transplant evaluation process.
- Lung transplant candidates exhibit substantial prehabilitation needs.
