A Randomized Trial of Exercise and Dietary Counseling After Liver Transplantation

• Published in: American journal of transplantation Vol. 6; no. 8; pp. 1896 - 1905
• Main Authors: Krasnoff, J. B., Vintro, A. Q., Ascher, N. L., Bass, N. M., Paul, S. M., Dodd, M. J., Painter, P. L.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01.08.2006
• Subjects: Adipose Tissue - pathology; Behavior modification; Body Height; Body Weight; Diet; Exercise; Female; Humans; Liver Transplantation; Male; Middle Aged; Muscles - physiology; nutrition; physical functioning; Quality of Life; rehabilitation; Time Factors
• ISSN: 1600-6135; 1600-6143
• DOI: 10.1111/j.1600-6143.2006.01391.x

We report results of a randomized clinical trial of a combined intervention of exercise and dietary counseling (ExD) after orthotopic liver transplantation (OLT). Of the 151 patients randomized into ExD or usual care (UC), 119 completed testing 2, 6 and 12 months post‐OLT. Testing included assessment of exercise capacity (VO2peak), quadricep muscle strength, body composition (DXA), nutritional intake (Block 95) and health‐related quality of life (SF‐36). The intervention consisted of individualized counseling and follow‐up to home‐based exercise and dietary modification. Repeated measure ANOVA was performed to determine differences over time between ExD and UC with a secondary analysis to determine differences over time between adherers (Adh), nonadherers (Nadh) to the intervention and UC. The ExD group showed greater increases in VO2peak (p = 0.036), and self‐reported general health (p = 0.038) compared to UC. Both groups demonstrated increases in muscle strength, body weight, body fat and other SF‐36 scale scores. Adherence to the intervention was 37% with positive trends in VO2peak and body composition observed in Adh compared to Nadh and UC. These data suggest improvements in exercise capacity and body composition are achieved with nutrition and exercise behavior modifications initiated early after OLT and with regular follow‐up. Nutrition and exercise modifications initiated early after orthotopic liver transplantation and subjected to regular follow‐up resulted in improvement in exercise capacity and body composition in this cohort of 115 liver transplant recipients randomized to either usual care or combined interventions.