A thorough assessment should take place by your GP or specialist before commencing your exercise program.
Accredited Exercise Physiologist (AEP)
It’s recommended you consult an Accredited Exercise Physiologist before you commence exercise, as it is essential for exercise prescription to be individualised according to your unique needs, including functional capacity, physical limitations, exercise history and preferences.
Exercise can then be supervised by an Accredited Exercise Physiologist.
When can organ transplant recipients start exercising after transplantation?
It is important to seek medical approval prior to engaging in any exercise following solid-organ transplantation. Transplant recipients have commenced aerobic exercise training in as little as 8 weeks following surgery (7). It is suggested that exercise-induced improvements in health are maximised if patients commence exercise training within the first year after surgery (6).
Exercise considerations before and after transplantation
The following factors should be considered when designing an exercise program:
- Patients should be medically stable, compliant with medication use and seek medical approval before commencing exercise.
- During exercise, patients with chronic heart failure may experience low blood pressure, which can cause light-headedness, sweating, fainting, distress, anxiety and abnormal heart rhythms.
- Exertional breathlessness is common in people with chronic obstructive pulmonary disease that may lead to hypoxemia (low oxygen in the blood).
- Patients receiving haemodialysis for end-stage kidney disease should restrict upper limb activity with temporary or healing fistula. Additionally, exercise should be performed in the first two hours of haemodialysis to avoid significant alterations in blood pressure.
- Gastroesophageal varices (abnormally enlarged veins due to liver cirrhosis) in end-stage liver disease must be managed prior to exercise. These patients may experience significant abdominal ascites (excess fluid accumulation), which can result in abdominal pain, discomfort and shortness of breath.
- Heart and lung transplant recipients should be cautious regarding upper body resistance training. It is recommended that patients do not perform strenuous upper body and arm training for 8 to 12 weeks or until clearance is obtained from the transplant surgeon.
- When performing resistance training, advise patients to maintain normal breathing and avoid holding their breath. The Valsalva maneuver (exhaling against a closed airway) may cause excess pressure in the chest and abdomen.
- In the unfortunate instance of organ rejection, it is recommended to reduce exercise intensity and duration but maintain low-levels of physical activity.
- If diabetic, monitor blood pressure and blood glucose before and after exercise.
- Common complications associated with a standard immunosuppression regime can include an increased infection susceptibility, high blood pressure, high blood glucose and increased risk of osteoporotic-related vertebral and hip fractures. Please consult a medical professional regarding these complications before commencing exercise.