Morkane, CM;
Kearney, O;
Bruce, D;
Melikian, C;
Martin, DS;
(2020)
An Outpatient Hospital-based Exercise Training Program for Patients With Cirrhotic Liver Disease Awaiting Transplantation: A Feasibility Trial.
Transplantation
, 104
(1)
pp. 97-103.
10.1097/tp.0000000000002803.
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Abstract
Background: Time spent on the waiting list prior to liver transplantation (LT) provides an opportunity to optimise recipient fitness through prehabilitation; potentially reducing the physiological impact of major surgery. We assessed the feasibility and effectiveness of a six-week exercise programme in patients with cirrhotic liver disease awaiting LT. / Methods: This single centre, prospective cohort, feasibility study, enrolled patients awaiting LT to a six week period of thrice weekly, supervised exercise on a static bike. Cardiopulmonary exercise testing (CPET) was used to objectively assess cardiopulmonary fitness at baseline and after six weeks of exercise. A follow-up CPET was performed at 12 weeks. CPET-derived measures were used to guide prescription of the training programme. A non-randomised control cohort of LT patients were selected to match the exercise group based on specific demographic data. Allocation to study arms was primarily based on the distance participants lived from the hospital where training occurred. Both groups received structured nutritional advice. / Results: The exercise programme was feasible, with 9/16 (56%) patients completing the full programme of six weeks. Peak oxygen consumption (VO2peak) in the exercise group rose from a mean (SD) of 16.2 (± 3.4) ml/kg/min at baseline to 18.5 (±4.6) ml/kg/min at week 6 (p=0.02). In the control group VO2peak decreased from a mean (SD) of 19.0 (± 6.1) ml/kg/min to 17.1 (±6.0) at week 6 (p=0.03). / Conclusion: We have demonstrated that it is feasible to engage patients awaiting LT in an intensive aerobic exercise programme with a signal of improvement in fitness being detected.
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