Exercise and organ transplantation

Abstract

Life‐saving treatment of disease by organ transplantation has become increasingly important. Annually over 35 000 transplantations of vital organs are carried out world‐wide and the demand for knowledge regarding exercise in daily life for transplant recipients is growing. The present review describes whole‐body and organ reactions to both acute exercise and regular physical training in persons who have undergone heart, lung, liver, kidney, pancreas or bone marrow transplantation. In response to acute exercise, the majority of cardiovascular, hormonal and metabolic changes are maintained after transplantation. However, in heart transplant recipients organ denervation reduces the speed of heart rate increase in response to exercise. Furthermore, lack of sympathetic nerves to transplanted organs impairs the normal insulin and renin responses to exercise in pancreas and kidney transplant recipients, respectively. In contrast, surgical removal of sympathetic liver nerves does not inhibit hepatic glucose production during exercise, and denervation of the lungs does not impair the ability to increase ventilation during physical exertion. Most studies show that physical training results in an improved endurance and strength capacity in almost all groups of transplant recipients, which is of importance for their daily life. With a little precaution, organ transplant recipients can perform exercise and physical training and obtain effects comparable with those achieved in the healthy population of similar age.

Transplant Recipients' Experience of Participation at the World Transplant Games in Gothenburg 2011: A Study of Psychological Well-being

“…Given the quotation in the introduction [4], which, in essence, states that it is the comradeship of peers, the return to being physically active again and the triumph of coping with adversities in life that give the games their unique flavor, it is no surprise that the apparently reappraised attitude towards the competitive aspects of the games are diminished and partly replaced by other basic needs for participation, such as social and wellbeing factors. This notion is also stressed by [1,5] , who emphasize several advantages of physical training for transplanted athletes, such as improved quality of life rather than mere competition. It is also interesting to note the relatively high educational level of participants at the WTG (62% university degree) as compared to statistics from other Western countries in relation to educational background and sport participation.…”

“…Previous research has clearly pointed out several medical and physical benefits for participation in physical activity aimed at this group, such as physical training resulting in improved endurance, strength and capacity in almost all groups of transplant recipients [1]. Other studies generally state that transplant recipients tolerate progressive exercise training well and can achieve levels of functioning similar to, or even higher than, those of the general population [2].…”

“…[1] State that physical training helps the transplanted athletes to heighten their mental readiness for life, and [4] writes about the benefits for the individual to overcome stressors in everyday life. In addition, [2] maintains the advantages of physical activity for increasing the general well-being of individuals.…”

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“…With properly selected physical activity, patients can obtain results comparable to healthy individuals at a similar age. 19 Although this study shows the benefits of exercise in patients after liver transplant, very few studies have focused on the assessment of physical activity in patients after liver transplant, and a lack of standardized testing methods makes it difficult and often impossible to compare results with other papers. In summary, in this cross-sectional prospective study, we have shown that female patients remain significantly less physically active than male patients after liver transplant.…”

Characterizing Dietary Intake and Physical Activity Affecting Weight Gain in Kidney Transplant Recipients

“…96 Blood pressure is also affected in kidney transplant recipients due to denervation of the transplanted kidney, so blood pressure could be higher in these individuals following exercise. 98 To illustrate these cardiovascular issues, researchers employing a prospective research design tested exercise capacity in 16 kidney transplant recipients for 2 years following transplantation. Peak oxygen consumption (VO 2 max) was significantly lower in the transplant recipient group compared to the healthy control group at 1, 4 and 10 months but not at 16, 24 and 48 months.…”