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Review
. 2024 Feb 13:37:12448.
doi: 10.3389/ti.2024.12448. eCollection 2024.

Physical Exercise After Solid Organ Transplantation: A Cautionary Tale

Dimitri Stylemans  1 , Marieke Vandecruys  2 , Sofie Leunis  3 , Sofie Engelborghs  4 , Davide Gargioli  4 , Diethard Monbaliu  3   5   6 , Véronique Cornelissen  7 , Amaryllis H Van Craenenbroeck  2   8 , Stefan De Smet  4
Affiliations
Review

Physical Exercise After Solid Organ Transplantation: A Cautionary Tale

Dimitri Stylemans et al. Transpl Int. .

Abstract

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.

Keywords: SOT, solid organ transplant; adverse event; critical appraisal; exercise; methodological appraisal; physical activity; side effects.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

FIGURE 1
FIGURE 1
Potential adverse outcomes of participation in posttransplant strenuous physical activity conducted in challenging environmental conditions.
FIGURE 2
FIGURE 2
Common methodological concerns present in the current literature regarding physical activity and exercise interventions after solid organ transplantation.
See this image and copyright information in PMC

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Grants and funding

This work was funded by the Research Foundation Flanders (FWO-SBO project number S006772N). SL and SDS were financially supported by C2-M (26M/21/001) KU Leuven grant. SE and SD were financially supported by B2023-Bijzonder Onderzoeksfonds 2023 KU Leuven research grant. DM is a senior researcher of The Research Foundation (FWO) Flanders and is recipient of a Centrale Afdeling Voor Fractionering chair for abdominal transplant surgery.