Physical Condition, Glycemia, Liver Function, and Quality of Life in Liver Transplant Recipients After a 12-Month Supervised Exercise Program

Background and aims Despite the excellent long-term outcomes in liver transplant (LT) recipients, several medical complications related to lifestyle represent still an issue. This study examined the effects of a 12-months supervised aerobic and strength training on the aerobic capacity, muscle strength, metabolic profile, liver function and quality of life in a cohort of LT recipients. Methods LT recipients from with stable liver function were assigned to interventional exercise (group A) or usual care (group B). Aerobic capacity, muscle strength, metabolic profile, liver and kidney function, and health-related quality of life were assessed at baseline, after 6 and 12 months. Group A attended supervised training sessions 3 times per week for 12 months. Group B received general recommendations about home-based exercise. Results Forty patients from 6 Italian LT Centers were randomized. Twenty-nine (72.5%, M/F 23/6, mean age 52±8 years) LT recipients completed the study. Baseline characteristics were similar between groups except for BMI and time from LT. No episode of acute rejection nor increase of transaminases occurred. Maximum workload and BMI increased in both groups over time, but fasting glucose significantly decreased in group A (94±15 vs 90±17 mg/dl; p=0.037) and increased in controls (95±24 vs 102±34 mg/dl, p=0.04). Upper limb muscle strength increased only in supervised LT recipients. Vitality, general and mental health domains significantly improved after physical exercise. Conclusions Supervised combined training was safe and effective in increasing aerobic capacity, muscle strength and quality of life and in improving glucose metabolism in stable LT recipients.