Page 162 - Physical activity in recipients of solid organ transplantation - Edwin J. van Adrichem

Chapter 8
important risk factor in recipients of solid organ transplantation and clearly linked to
functional exercise capacity.

e mechanism of muscle wasting in the transplant population
is not completely understood, and it is unknown if the process is reversible. Frailty is
described as a state of functional decline and increased vulnerability to adverse health
outcomes. It is associated with increased in
system.

ammation and a dysregulation of the immune

e indicated prevalence in recipients of solid organ transplantation varies by organ
type and measurement method but seems to be notably higher than in the community
dwelling elderly population (average prevalence of ~25% in recipients of transplantation vs.
~7% in the community dwelling elderly).
di

erent de

However, literature is sparse and limited by
di
nitions of muscle wasting (sarcopenia/cachexia) and frailty and as well as by

erent measurement methods to assess these concepts. No standardized treatment is
described, however, adequate nutrition and resistance training appear to be key for reducing
or preventing muscle wasting and frailty.
-
organ transplantation. Research has shown that the immune system of healthy individuals
bene

ts from regular moderate-intensity physical activity.
transiently suppressed by prolonged exhaustive exercise.
the number and function of circulating cells of the innate immune system
it has been speculated that recipients of transplantation who engage in regular physical
activity may require less maintenance immunosuppressive medication.
Concluding remarks
48
47
Exercise and the immune system in recipients of solid organ transplantation:
Although a number of initial studies have been performed, such as the example provided in
Chapter 7 of the current thesis, there continues to be insu

cient knowledge regarding the
e
ects of strenuous exercise on transplant recipients. Especially regarding the interaction
between exercise and the immunosuppressive e

ect of medication in recipients of solid
49

is e

ect, however, can be
Acute and chronic exercise alter 49

and, therefore,
e plus side of
this decrease in medication would be that the short and long-term adverse drug e
50

ects of
the use of immunosuppressive medication would be reduced.
Based on this thesis, it can be concluded that, although there is wide variability in the level
of physical activity in recipients of solid organ transplantation and measurement methods
have their limitation, the majority of recipients do not meet the recommended level of
physical activity. No signi

cant and overt di

associated with the level of physical activity were ascertained between the di

erent
transplant groups.

transplantation groups.
erefore, the relevance of intervention development and the majority of
the content of rehabilitation or physical therapy interventions is equal for all

e experienced barriers, facilitators and psychological components
and not the type of transplantation are suggested to in
erences in physical activity and factors

uence the level of physical activity.
Given the interdisciplinary approach in healthcare in transplantation, all healthcare
providers should work together to increase the level of physical activity in this population.
Healthcare providers should take responsibility in su

ciently assessing the level of physical
160.