Safety, adherence and efficacy of a 4-week randomised-controlled trial of exercise training in patients awaiting liver transplantation

Matthew Wallen, Shelley E. Keating, Adrian Hall, Tina L. Skinner, Aidan J. Woodward, Graeme A. Macdonald, Jeff Coombes

Research output: Contribution to journalMeeting Abstractpeer-review


Background and Aims: Patients awaiting liver transplantation experience significant reductions in cardiorespiratory fitness and muscular strength that are associated with impaired post-operative outcomes. Exercise training effectively improves these fitness-related parameters. However, there are limited studies investigating exercise training in this population, likely due to safety concerns regarding potential complications e.g. portal hypertension. The aim of this study was to investigate the safety, adherence and efficacy of exercise training in patients awaiting liver transplantation.
Methods: Fourteen patients (age 44.3 ± 14.9 years, 93% male) awaiting liver transplantation (model of end-stage liver disease score: 12 [7–19]; hepatocellular carcinoma diagnosis: 50%; mild or diuretic controlled ascites: 28.5%) were randomised to either exercise (60 minutes, aerobic exercise corresponding to the ventilatory threshold and resistance training performed at 70–80% of one repetition maximum, 2 days/week supervised, 1 day/week unsupervised) or usual care. Safety was quantified as adverse events per number of training hours and hospital admissions during the intervention. Adherence was assessed from the number of sessions completed and reported. Efficacy was determined as changes in peak oxygen uptake, ventilatory threshold and muscular strength. Values are reported as mean ± standard deviation.
Results: There were no serious adverse events (including variceal haemorrhage or hepatic encephalopathy) requiring hospital admission during exercise training or the interventional period. Only one adverse event (knee injury) occurred in 168 training hours. Adherence to the prescribed training sessions was high (87.5%). A significant improvement was found for the exercise group compared to usual care for peak oxygen uptake (+19.1 ± 17.0% vs. −6.77 ± 17.1%, p = 0.03) but not ventilatory threshold (+11.7 ± 28.7% vs. 0.5 ± 24.1%, p = 0.4). Improvements in grip strength were observed following exercise training, however did not reach significance compared to usual care (+16 ± 5.6% vs. −10.0 ± 19.4%, p = 0.07).
Conclusions: Patients awaiting liver transplantation adhered to a 4-
week exercise intervention without liver disease-related
complications. Training resulted in a significant improvement in
peak oxygen uptake compared to usual care. Whether this translates
into peri-operative benefits requires further investigation.
Original languageEnglish
Article numberFRI-476
Pages (from-to)s548
Number of pages1
JournalJournal of Hepatology
Issue number2 Suppl.
Publication statusPublished - 2016
Externally publishedYes


  • liver transplantation
  • exercise program
  • patient outcomes


Dive into the research topics of 'Safety, adherence and efficacy of a 4-week randomised-controlled trial of exercise training in patients awaiting liver transplantation'. Together they form a unique fingerprint.

Cite this