Factors associated with early postoperative exercise tolerance after living‐donor liver transplantation

• DOI: 10.1111/ctr.14800
• Publication Date: 2022-08-22T10:10:30Z
• Authors: Yuji Yoshioka; Yohei Oshima; Koichiro Hata; Susumu Sato; Ryota Hamada; Tatsuya Sato; Toshimi Kaido; Fumiaki Munekage; Takashi Ito; Ryosuke Ikeguchi; Shinji Uemoto; Etsuro Hatano; Shuichi Matsuda
• Keywords: 03 medical and health sciences; Exercise Tolerance; 0302 clinical medicine; Living Donors; Humans; Postoperative Period; Liver Transplantation; Retrospective Studies

AbstractBackgroundPhysical dysfunction, including exercise intolerance, is a major factor for delayed societal reintegration for patients who underwent living‐donor liver transplantation (LDLT). However, what may contribute to early postoperative physical function is not well known. The purpose of this study is to elucidate the perioperative factors affecting early posttransplant exercise intolerance.Methods103 consecutive patients who underwent LDLT were enrolled, and 68 patients were retrospectively analyzed. We examined the relationship between postoperative exercise tolerance evaluated by a 6‐minute walking distance (6MWD) at discharge after surgery and demographic data, surgical information, preoperative physical function, clinical course, and the postoperative decline in physical function with univariate and multivariate analyses.ResultsAlmost all patients were discharged within 3 months after surgery. The postoperative 6MWD was 408 ± 94 m (68 [61–84]% of the predicted value), and patients who had a low %6MWD at discharge had significantly lower preoperative physical function than patients who had a high %6MWD at discharge (grip strength: 29.8 ± 8.9 kgf vs. 23.0 ± 8.8 kgf, P < .01, knee extensor strength: 138.9 ± 59.4 Nm vs. 95.2 ± 42.1 Nm, P < .01). Multivariate analysis revealed that preoperative knee extensor strength (standardized β = 0.35, P < .01) and first postoperative walking day (standardized β = −0.22, P = .04) were independently associated with the postoperative %6MWD.ConclusionThese results suggest that maintaining preoperative muscle strength and allowing for early postoperative mobilization might help to enhance the recovery of physical function and facilitate the patient's social reintegration after LDLT.