Exercise Training Before and After Lung Transplantation

Abstract

The benefits of exercise training in individuals with chronic lung diseases such as chronic obstructive pulmonary disease, cystic fibrosis, and interstitial lung disease have been well documented. Although there is limited research available, it appears that exercise is safe and beneficial for people with severe end-stage chronic lung disease who are awaiting lung transplantation in addition to recipients of lung transplants. Evidence-based guidelines for exercise training in the pre- and post-lung transplantation phases have not yet been developed. However, by considering exercise guidelines for people with chronic lung disease and in older adults in light of the physiological changes that can occur either pre- or post-lung transplantation, a safe and appropriate exercise training program can be developed. Depending on the individual's exercise capacity and goals, the training program may include aerobic and resistance exercise, and flexibility and balance training. In the pre-transplant and acute post-transplant phases, the intensity of exercise is dictated primarily by symptom limitation and adequate rest, which is required between exercise bouts to allow for recovery. In the post-transplant phase, it is possible for lung transplant recipients to increase their exercise capacity and even participate in sports. Further research needs to be conducted to determine the optimal training guidelines and the long-term benefits of exercise, both in lung transplant candidates and recipients.

Factors affecting discharge destination following lung transplantation

“…Based on the previous literature in solid organ transplant , we hypothesized that the following factors would be associated with discharge destination: age at the time of transplant, body mass index (BMI), pre‐transplant diagnosis, priority status for transplant, transplantation from mechanical ventilation, participation in pre‐transplant rehabilitation, pre‐transplant functional exercise capacity, type of transplant, pre‐ and post‐transplant intensive care unit (ICU) length of stay (LOS), and total LOS. The objectives of this study were to (i) describe the discharge destinations after LT, (ii) compare the characteristics of patients discharged to different destinations, and (iii) identify the predictors of discharge to inpatient rehabilitation.…”

Practical Guidelines: Lung Transplantation in Patients with Cystic Fibrosis

“…Preoperative rehabilitation aims to achieve optimum conditioning with regard to strength, endurance, mobility in everyday life and nutritional condition, at creating a better starting point for the transplantation thereby making for a better postoperative outcome [163]. …”

La transplantation pulmonaire: avant, pendant et après… — Bénéfices de la transplantation pulmonaire et de la réadaptation

“…Un programme d'entraînement physique est indispensable pour inverser les effets néfastes du traitement immunosuppresseur et reconditionner les muscles squelettiques à l'effort [20,28]. Des séances contenant des exercices d'endurance (vélo, tapis de marche…) et de renforcement musculaire global sont efficaces pour améliorer la force, le métabolisme et l'endurance.…”