Exercise interventions in solid organ transplant candidates: A systematic review

Abstract

Solid organ transplantation (SOT) saves the lives of patients suffering from end-stage liver, heart, kidney, pancreas, and lung diseases 1,2 and improves disease-related symptoms as well as the quality of life (QoL) in these individuals. 3 Recent statistics show that close to 100 800 solid organ transplants are performed every year worldwide. 4 Many SOT candidates suffer from chronic disease for years before receiving a transplant, and depending on their health condition and which organ is involved, multiple systems may be compromised. 5,6 Studies have shown that SOT candidates experience limitations in exercise capacity secondary to central and peripheral factors 6-9 which may impact their levels of daily physical activity 10-13 and consequently on the psychosocial aspects of their lives. 14 In the general population, physical inactivity reduces normal functioning of major organ systems such as the cardiovascular, cardiopulmonary,

Prehabilitation in adult patients undergoing surgery: an umbrella review of systematic reviews

“…Whilst data were inadequate to perform a GRADE assessment, two reviews, comprising 23 individual studies, found no differences in intervention-attributable cardiopulmonary adverse events between prehabilitation and control arms (Supplementary Appendix 7). 51,52…”

“…The majority of included reviews had critical weaknesses and were rated as critically low (26; 47%) 21e23,47,53e73 or low (16; 29%) 25,49,50,74e86 quality. Only four reviews were rated as high quality (7%), 51,52,87,88 seven (13%) were rated as moderate quality, 48,89e94 and two (4%) as unclear. 95,96 A full description is provided in Supplementary Appendix 8.…”

The impact of frailty on mortality after heart transplantation

“…A systematic review of exercise pre-habilitation in the patients awaiting solid organ transplantation identified 23 studies. 27 Patient acceptance ranged from 16% to 100%. None of the studies reported any serious adverse effects of pre-habilitation, suggesting that this is a safe intervention even in those with advanced heart failure.…”

Frailty of the Heart Recipient

“…In the systematic review cited previously, patient acceptance ranged from 16% to 100%. 71 Cognitive impairment and depression, both common in the advanced heart failure population, may reduce patient acceptance and adherence to a structured prehabilitation program. While no studies have reported any adverse effects of prehabilitation, 71 there remains a reluctance among some exercise trainers and physiotherapists to supervise exercise programs in frail patients with advanced heart failure.…”