Digestive Diseases and Sciences

, Volume 63, Issue 12, pp 3290–3296 | Cite as

Patient and Caregiver Attitudes and Practices of Exercise in Candidates Listed for Liver Transplantation

  • David M. ChascsaEmail author
  • Jennifer C. Lai
  • Michael A. Dunn
  • Aldo J. Montano-Loza
  • Matthew R. Kappus
  • Srinivasan Dasarathy
  • Elizabeth J. Carey
Original Article



Impaired physical capacity increases peri-liver transplant complications. Patient perceptions regarding exercise prior to transplantation are not known.


This study aimed to assess patient and caregiver activity levels, perceptions of willingness to exercise, and of provider advice.


Consecutive patients listed for liver transplant and caregivers presenting for routine outpatient visits were evaluated over a 3-month interval. Anonymous surveys adapted to patients and caregivers addressed the importance and safety of exercise, type and duration of exercise performed, barriers, willingness to wear a monitoring device, and perceived provider recommendations. Responses were logged on a Likert scale from 1 to 5.


Three hundred and sixty-eight responses were received. Most participants perceived exercise as important. Patients exercised three times per week for 30 min. Eighty percent endorsed walking (median response: 2—agree; IQR 1–2). Most did not jog, swim, cycle, or strength train. Fatigue, reported by 70%, was the major barrier (2, IQR 1–3). Over 90% of caregivers endorsed exercise as important (1—strongly agree, IQR 1–2) and encouraged exercise (median response 2, IQR 1–2). Over 60% of patients (median response 2, IQR 1–3) and caregivers (median response 2, IQR 2–3) felt providers encouraged exercise.


Patients and caregivers are willing to exercise to optimize physical fitness prior to liver transplantation.


Physical capacity Exercise Liver transplantation Patient Caregiver 



Fitness, life enhancement, and exercise in transplantation


Liver transplant


Model for end-stage liver disease


Author’s contributions

J. Lai, M. Dunn, A. Montano-Loza, M. Kappus, and E. Carey designed the study, collected the data, and provided significant input regarding manuscript composition. D. Chascsa analyzed the data and composed the manuscript. S. Dasarathy assisted in study design and provided significant input regarding manuscript composition.


Funding was provided by National Institute on Aging (Grant No. K23AG048337).

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Supplementary material

10620_2018_5271_MOESM1_ESM.docx (62 kb)
Supplementary material 1 (DOCX 62 kb)
10620_2018_5271_MOESM2_ESM.docx (60 kb)
Supplementary material 2 (DOCX 59 kb)


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Division of Gastroenterology and HepatologyMayo Clinic in ArizonaPhoenixUSA
  2. 2.Division of Gastroenterology and HepatologyUniversity of California San FranciscoSan FranciscoUSA
  3. 3.Center for Liver Diseases, Pittsburgh Liver Research Center and Thomas E. Starzl Transplantation InstituteUniversity of PittsburghPittsburghUSA
  4. 4.Division of Gastroenterology and Liver UnitUniversity of AlbertaEdmontonCanada
  5. 5.Division of Gastroenterology and HepatologyDuke UniversityDurhamUSA
  6. 6.Division of Gastroenterology and HepatologyCleveland ClinicClevelandUSA

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