Effects of Perioperative Rehabilitation on Physical Function in Kidney Transplant Recipients

Sarcopenia and frailty are common among kidney transplant candidates and often persist even after transplantation. Exercise therapy initiated during the perioperative period may improve physical function, but its benefits remain underexplored.

We conducted a single-center prospective observational study evaluating a structured rehabilitation protocol in kidney transplant recipients. Patients received supervised exercise therapy starting from postoperative day (POD) 2, followed by resistance training and aerobic exercise during hospitalization. Upon discharge, participants were instructed to continue monthly supervised training sessions. Outcomes including skeletal muscle index (SMI), handgrip strength, gait speed, anaerobic threshold VO₂, and peak VO₂ were assessed before transplant and at 1 year post-transplant. Improvement rates were compared between patients who received rehabilitation and those who did not, and further among those who continued post-discharge training.

Patients in the rehabilitation group showed significantly greater improvements in grip strength, gait speed, and VO₂ parameters compared to the control group (p < 0.05). Among the rehabilitation group, those who continued training post-discharge for ≥6 months exhibited the most pronounced improvements. No adverse effects on renal function were observed.

Early and sustained rehabilitation is effective and safe for improving physical function in kidney transplant recipients. Incorporating structured exercise therapy into routine perioperative and post-discharge care may enhance recovery and clinical outcomes.