Prehabilitation uses lifestyle and mental health interventions before surgery. This makes outcomes better.
It’s somewhat new in transplant medicine. But research suggests it can benefit patients.
Prehabilitation is an effective and safe process for solid organ transplants. That’s according to a 2023 review in Current Transplantation Reports. These include:
UPMC started its prehabilitation program in 2020. It aimed to support the health of lung transplant candidates. It expanded to support patients in need of a heart transplant in 2023.
Karen Barr, MD, physiatrist, UPMC Rehabilitation Institute, and associate professor, University of Pittsburgh Department of Physical Medicine and Rehabilitation, leads the program.
The program is one way UPMC helps heart and lung transplant candidates. It supports them through every stage of their journey.
We provide resources to transplant patients with physiological and psychological challenges. These challenges can impact recovery from surgery.
Take a closer look at our program. Learn why it’s so vital to better outcomes.
How Does UPMC’s Prehabilitation Plan Benefit Heart and Lung Transplant Candidates?
Identifying frailty and building a prehabilitation plan for heart and lung transplant candidates
Frailty is a person’s ability to recover from illness and other health problems. Frailty can predict complications from surgery.
UPMC checks every heart and lung transplant candidate for health issues. We also measure muscle weakness and fitness for surgery.
The transplant patient also gets a plan that focuses on three areas:
- Nutritional status
- Physical condition
- Psychological resilience
Many transplant candidates can’t exercise. This is because of their heart or lung failure problems.
Therapy for weaker patients may begin with small movements. They may include breathing exercises and a slow increase in activity.
Malnutrition is common among transplant candidates. This can happen because of poor appetite. Medication effects or weight restrictions are also possible causes.
The prehabilitation program works with dietitians. This ensures patients get the nutrients they need. It can help rebuild strength or manage weight while maintaining muscle mass.
The program also addresses mental health. The emotional burden of waiting for a transplant can lead to depression and anxiety. So can chronic illness.
Individualizing care based on patient needs
Prehabilitation is not one-size-fits-all. Each plan considers unique health factors. It also considers the timeline for transplant.
Some patients may have months or longer to prepare. Others may have only weeks. The goal is to make meaningful improvements regardless.
Some transplant centers may ask patients to move for prehabilitation. UPMC’s model is more flexible.
Our patients can get care within their own communities. They can remain with their support systems while getting the care they need.
Applying lifestyle medicine
A holistic approach to care is key to transplant prehabilitation at UPMC. This approach includes practices from lifestyle medicine.
Dr. Barr became a diplomate of the American Board of Lifestyle Medicine in December 2024. This certification recognizes expertise in lifestyle interventions.
These include nutrition, physical activity, and sleep. They also include stress management and behavioral change. This can improve outcomes.
Including lifestyle medicine is unique. It can improve patient health as much as possible before a transplant. It also sets patients up for long-term success.
Advancing research and international collaboration
The prehabilitation program also supports transplant research and education beyond patient care. One of its major areas of interest is muscle mass as a marker of frailty. This continued research is important to giving patients the best care.
Supporting patients after transplantation
Prehabilitation is only one part of a long-term strategy. UPMC’s program is one of the first in the country to tackle prehabilitative needs. It does this for heart and lung transplant candidates through a coordinated approach.
It also includes rehabilitation in every stage of the process. It spans the first evaluation through recovery. This results in better outcomes and long-term health.
Sources
Current Transplantation Reports. Prehabilitation in Adult Solid Organ Transplant Candidates. Accessed September 2025. https://pmc.ncbi.nlm.nih.gov/articles/PMC10039771/ NIH.gov