Prehabilitation in patients with cirrhosis awaiting liver transplantation: protocol of a feasibility study.

Autor:	Benmassaoud A; Division of Gastroenterology and Hepatology, McGill University Health Centre, Montreal, Quebec, Canada amine.benmassaoud@mcgill.ca., Gillis C; School of Human Nutrition, McGill University, Montreal, Quebec, Canada., Geraci O; Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada., Martel M; Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada., Awasthi R; PeriOperative Program, McGill University Health Centre, Montreal, Quebec, Canada., Barkun J; Department of Surgery, McGill University Health Centre, Montreal, Quebec, Canada., Chen T; Division of Gastroenterology and Hepatology, McGill University Health Centre, Montreal, Quebec, Canada., Edgar L; PeriOperative Program, McGill University Health Centre, Montreal, Quebec, Canada., Sebastiani G; Division of Gastroenterology and Hepatology, McGill University Health Centre, Montreal, Quebec, Canada., Carli F; Department of Anesthesia, McGill University Health Centre, Montreal, Quebec, Canada., Bessissow A; Department of Medicine, McGill University Health Centre, Montreal, Quebec, Canada.
Jazyk:	angličtina
Zdroj:	BMJ open [BMJ Open] 2024 Jun 25; Vol. 14 (6), pp. e081362. Date of Electronic Publication: 2024 Jun 25.
DOI:	10.1136/bmjopen-2023-081362
Abstrakt:	Introduction: Patients with cirrhosis awaiting liver transplantation (LT) are often frail, and malnourished. The period of time on the waitlist provides an opportunity to improve their physical fitness. Prehabilitation appears to improve the physical fitness of patients before major surgery. Little is known about prehabilitation in patients with cirrhosis. The aim of this feasibility study will be to investigate the feasibility, safety, and effectiveness of a multimodal prehabilitation programme in this patient population. Methods and Analysis: This is an open-label single-arm feasibility trial recruiting 25 consecutive adult patients with cirrhosis active on the LT waiting list of the McGill University Health Centre (MUHC). Individuals will be excluded based on criteria developed for the safe exercise training in patients with cirrhosis. Enrolled individuals will participate in a multimodal prehabilitation programme conducted at the PeriOperative Programme complex of the MUHC. It includes exercise training with a certified kinesiologist (aerobic and resistance training), nutritional optimisation with a registered dietician and psychological support with a nurse specialist. The exercise training programme is divided into an induction phase with three sessions per week for 4 weeks followed by a maintenance phase with one session every other week for 20 weeks. Aerobic training will be individualised based on result from cardiopulmonary exercise testing (CPET) and will include a high-intensity interval training on a cycle ergometer. Feasibility, adherence and acceptability of the intervention will be assessed. Adverse events will be reviewed before each visit. Changes in exercise capacity (6-minute walk test, CPET, liver frailty index), nutritional status and health-related quality of life will be assessed during the study. Post-transplantation outcomes will be recorded. Ethics and Dissemination: The research ethics board of the MUHC has approved this study (2021-7646). Our findings will be submitted for presentation at national and international conferences, and for peer-reviewed publication. Trial Registration Number: NCT05237583. Competing Interests: Competing interests: None declared. (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu