Lung Transplant Patients on Kilimanjaro

Gieszer, Balázs; Radeczky, Péter; Farkas, Attila; Csende, Kristóf; Mészáros, László; Török, Klára; Fazekas, Levente; Bogyó, Levente; Acsády, László; Kocsis, Ákos; Varga, János; Bartók, Tibor; Dancs, Tamás; Tóth, Krisztina; Schönauer, Nóra; Madurka, Ildikó; Elek, Jenö; Döme, Balázs; Rényi-Vámos, F; Láng, György; Jaksch, Péter; Ghimessy, Áron

doi:10.1016/j.transproceed.2019.04.004

Cited by 3 publications

(5 citation statements)

References 10 publications

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“…The current literature indicates comparable summitting success rates in well-trained transplant recipients compared to healthy controls [ 8 ]. Normal physiological responses, including changes in oxygen saturation and heart rate, appear largely similar to those observed in healthy controls when exposed to increasing altitudes [ 7 , 8 , 96 – 98 ]. However, a higher incidence of arterial hypertension in liver transplant patients has been reported [ 98 ], and higher altitude sickness scores have been reported in lung transplant recipients [ 7 ].…”

Section: Organ Systems At Riskmentioning

confidence: 84%

Physical Exercise After Solid Organ Transplantation: A Cautionary Tale

Stylemans,

Vandecruys,

Leunis

et al. 2024

Transpl Int

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An increasing body of randomized controlled trials suggests the safety of engaging in moderate to vigorous intensity exercise training following solid organ transplantation. Fueled by emerging sport events designed for transplant recipients and the ever-growing body of research highlighting the diverse health benefits of physical activity, transplant recipients are now increasingly participating in strenuous and occasionally competitive physical endeavors that largely surpass those evaluated in controlled research settings. This viewpoint article adopts a cautionary stance to counterbalance the prevalent one-sided optimistic perspective regarding posttransplant physical activity. While discussing methodological limitations, we explore plausible adverse impacts on the cardiovascular, immunological, and musculoskeletal systems. We also examine the physiological consequences of exercising in the heat, at high altitude, and in areas with high air pollution. Risks associated with employing performance-enhancing strategies and the conceivable psychological implications regarding physical activity as a tribute to the ‘gift of life’ are discussed. With a deliberate focus on the potential adverse outcomes of strenuous posttransplant physical activity, this viewpoint aims to restore a balanced dialogue on our comprehension of both beneficial and potentially detrimental outcomes of physical activity that ultimately underscores the imperative of well-informed decision-making and tailored exercise regimens in the realm of posttransplant care.

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Section: Organ Systems At Riskmentioning

confidence: 84%

Physical Exercise After Solid Organ Transplantation: A Cautionary Tale

Stylemans,

Vandecruys,

Leunis

et al. 2024

Transpl Int

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“…Of note, transplant patients showed worse respiratory alkalosis and hypocapnia 4 . The first expedition focusing on lung transplant recipients was conducted by the Vienna Lung Transplant Program in 2017 5 . The expedition consisted of 10 recipients and 24 accompanying physicians.…”

Section: Discussionmentioning

confidence: 99%

“…However, poor cardiorespiratory fitness and muscle weakness are commonly persistent despite normalization of pulmonary function 2 . Although high‐altitude trekking has been reported after transplantation, data on the patient's physiological adaptation during prolonged strenuous exercise in a reduced oxygen environment remain scarce 3–5 …”

Section: Introductionmentioning

confidence: 99%

“…The previous expedition of the Vienna Lung Transplant Program to climb Mount Kilimanjaro in June 2017 proved the feasibility and safety of high‐altitude mountaineering in LuTx recipients 3,5 . A second expedition was planned to expand our understanding of cardiopulmonary changes in lung recipients exposed to altitude, using more sophisticated medical monitoring methods.…”

Section: Introductionmentioning

confidence: 99%

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Cardiopulmonary response to high‐altitude mountaineering in lung transplant recipients—The Jebel Toubkal experience

Schrutka

Slama

Muehlbacher

et al. 2021

Scandinavian Med Sci Sports

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Objectives Only a small proportion of lung transplant recipients achieve a physical status comparable to healthy individuals in the long term. It is reasonable to hypothesize that the necessary cardiopulmonary adaptation required for strenuous physical exercise may be impaired. Exposure to high altitude provides an optimal platform to study the physiological cardiopulmonary adaptation in lung transplant recipients under aerobic conditions. To gain a deeper understanding, 14 healthy lung transplant recipients and healthcare professionals climbed the highest peak in North Africa (Mount Jebel Toubkal; 4167 m) in September 2019. Methods Monitoring included daily assessment of vital signs, repeated transthoracic echocardiography, pulmonary function tests, and capillary blood sampling throughout the expedition. Results Eleven out of fourteen lung transplant recipients reached the summit. All recipients showed a stable lung function and vital parameters and physiological adaptation of blood gases. Similar results were found in healthy controls. Lung transplant recipients showed worse results in the 6‐minute walk test at low and high altitude compared to controls (day 1: 662 m vs. 725 m, p < 0.001, day 5: 656 m vs. 700 m, p = 0.033) and a lack of contractile adaptation of right ventricular function with increasing altitude as measured by tricuspid plane systolic excursion on echocardiography (day 2: 22 mm vs. 24 mm, p = 0.202, day 5: 23 mm vs. 26 mm, p = 0.035). Conclusions Strenuous exercise in healthy lung transplant recipients is safe. However, the poorer cardiopulmonary performance in the 6‐minute walk test and the lack of right ventricular cardiac adaptation may indicate underlying autonomic dysregulation.

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“…34 Patients receiving LTx are expecting to restore their quality of life, and some can even get involved in sports activities or adventurous travels safely. 35,36…”

Section: Multidisciplinarity In Lung Transplantmentioning

confidence: 99%

Does Preoperative Rehabilitation Influence the Quality of Life in Patients Who Are Candidates for Lung Transplant?

Polastri¹,

Dell’Amore²,

Eden³

et al. 2022

Exp Clin Transplant

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Objectives: Lung transplant is an excellent therapeutic option for patients with advanced/end-stage pulmonary disease. The purpose of this review was to define whether preoperative rehabilitation influences quality of life in patients who are candidates for lung transplant. Materials and Methods:This was a scoping review conducted by searching 4 primary databases from inception until January 2022. Three keywords, "lung transplantation," "preoperative rehabilitation," and "quality of life," were matched using the Boolean operator AND. In each database, the following fields were searched: PubMed (all fields), Scopus (title, abstract, keywords), Cochrane Library (title, abstract, keywords), and Web of Science (topic). Filters were applied for age (adult only) and language (English only). No filters were applied for gender, publication date, and subject. The search process was completed in January 2022. Results and Conclusions:We retrieved 57 citations from these databases. After removal of duplicates, 41 documents were screened for eligibility. Two articles were included in the final analysis: 1 was a systematic review, and 1 was an observational prospective study. The rehabilitative interventions were mainly focused on motor and breathing exercises and were integrated by education programs. Preoperative rehabilitation was effective at improving quality of life and mood status and reducing dyspnea in patients waiting for lung transplant. In addition, the 6-minute walking distance increased after patients participated in preoperative rehabilitation. Preoperative rehabilitation was composed of different types of exercise with variable duration (3-20 weeks) and frequency (3-6 times per week). Patients on the active wait list for lung transplant should be encouraged to attend preoperative rehabilitation in order to preserve and improve their quality of life.

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Lung Transplant Patients on Kilimanjaro

Cited by 3 publications

References 10 publications

Physical Exercise After Solid Organ Transplantation: A Cautionary Tale

Physical Exercise After Solid Organ Transplantation: A Cautionary Tale

Cardiopulmonary response to high‐altitude mountaineering in lung transplant recipients—The Jebel Toubkal experience

Does Preoperative Rehabilitation Influence the Quality of Life in Patients Who Are Candidates for Lung Transplant?

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