Page 131 - Physical activity in recipients of solid organ transplantation - Edwin J. van Adrichem

Physical activity in recipients of solid organ transplantation
Introduction
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With the increased focus on long-term survival after organ transplantation, new questions
are emerging regarding physical possibilities and potential boundaries or limitations
following organ transplantation. Are physically demanding goals equally feasible for organ
transplant recipients (OTR) as they are for the non-transplanted population?

e reported
levels of physical activity (PA) are lower in OTR than that of the non-transplanted
population
even though organ functioning post-transplantation is nearly normal.7
Furthermore, maximal oxygen consumption is demonstrated to be signi

cantly reduced
with kidney and liver-tx recipients and lung and heart-tx recipients, respectively reaching
65–80% and 50–60% of predicted.7
exceptional environment, would not be feasible for OTR.

ese data suggest that strenuous PA, especially in an
However, carefully selected and prepared liver transplant recipients appear to be
equally tolerant to PA in, and exposure to, high-altitude as healthy controls.8
So far, it is
unknown if recipients of other types of organ transplantation are equally tolerant to PA
and exposure to high-altitude. Hence, a transplant recipients' initiative to climb Mount
Kilimanjaro was subsequently embraced by the Groningen Transplant Center. In addition
to increasing awareness of physical abilities after transplantation when a healthy lifestyle is
adhered to and increasing donor awareness, the aforementioned questions were studied
during the expedition.

e aims of the present study are to evaluate the physical response,
incidence of acute mountain sickness, and tolerance to strenuous PA at heights above 5000
meters for various OTR compared to non-transplanted controls. Based on the presented
results in liver transplant recipients and our clinical experience we hypothesize that well
prepared OTR will not clinically di

er from the non-transplanted controls.
Materials and Methods
Study design and participants
A prospective cohort study was performed in which OTR were compared to non-
transplanted controls during the preparation and expedition to the summit of Mount
Kilimanjaro (5895m), Tanzania.

e selection of OTR occurred in March and April 2014.
Possible participants were preselected by their treating physician. To be considered as
eligible, OTR had to be at least 12 months post-transplantation, have a stable
cardiopulmonary status, and have no signs of acute or chronic rejection in the previous 12
months. Furthermore, OTR were required to be between 18 and 60 years of age and have a
normal to active lifestyle. Exclusion criteria were renal dysfunction (creatinine clearance <
40ml/min.) and insulin dependent diabetes mellitus.
and an intake interview.

e selection of OTR occurred
following cardio pulmonary exercise testing (CPET), peripheral muscle strength testing,

e interview was directed at obtaining insight into the motivation
to participate, the coping style of the participant, and the experience and expectations with
camping in harsh conditions. As a control group we used a convenience sample consisting
of the members of the medical team and family members that accompanied the expedition.
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