Prehabilitation prior to kidney transplantation: Results from a pilot study

• DOI: 10.1111/ctr.13450
• Publication Date: 2018-11-21T16:18:27Z
• Authors: Mara A. McAdams‐D...; Hao Ying; Sarah Van Pilsum ...; Jennifer Schrack; Christine E. Haugen; Nadia M. Chu; Marlís González F...; Niraj Desai; Jeremy D. Walston; Dorry L. Segev
• Keywords: Prehabilitation; Stressor

Prehabilitation is the process of enhancing preoperative functional capacity to improve tolerance for upcoming stressor; it was associated with improved postoperative outcomes in a handful studies, but never evaluated transplantation. Kidney transplant (KT) candidates may be uniquely suited prehabilitation because they experience profound loss while waiting years on dialysis. To better understand feasibility and effectiveness KT, we conducted pilot study center-based candidates; this intervention consisted weekly physical therapy sessions at an outpatient center at-home exercises. We enrolled 24 participants; 18 participated (75% enrolled; 17% eligible). 61% were male, 72% African American, mean age = 52 (SD 12.9); 71% participants had lower-extremity impairment, 31% frail. By 2 months prehabilitation, their activity by 64% (P 0.004) based accelerometry. Participants reported high satisfaction. Among 5 who received KT during study, length stay shorter than age-, sex-, race-matched control (5 vs 10 days; RR 0.69; 95% CI:0.50-0.94; P 0.02). These findings suggest that feasible pretransplant patients potentially strategy post-KT outcomes.