Liver transplant patients at UHP to receive prehab via an app in UK first

The year-long trial with the South West Liver Unit at University Hospitals Plymouth NHS Trust will see 50 patients undergoing assessment and listing for liver transplant. If successful, the service may be expanded to patients living with other liver diseases and who currently are not on the list.

Prehab is a relatively new area of healthcare that focuses on improving the general health and activity of patients before surgery and treatment as a way of aiding their recovery.

Each patient will be able to access their individualised programmes via an app. Exercise classes and support sessions will be delivered by a combination of phone, Zoom or Skype calls. Those patients who do not have access to suitable technology will be able to loan equipment from the South West Liver Unit during the trial at no cost to themselves.

Patients who complete a prehab course prior to planned surgery are less likely to be readmitted to hospital, enjoy improved health-related quality of life, return to work earlier and need less involvement with social and primary care providers.

The aim of the trial is to demonstrate two pivotal elements:

• The feasibility of remote delivery of prehab and the benefits in health-related quality of life for patients awaiting liver transplant
• How the time spent waiting for surgery can be utilised in a positive and clinically effective manner, as 50% of patients listed for transplant typically have a wait of six months or more

“We’re very excited to have the opportunity to expand much-needed support to our patients here in the south west,” said Professor Matthew Cramp, Consultant Hepatologist at the South West Liver Unit, UHP. 

“Liver transplant patients face many challenges and to be able to provide a personalised prehab service while they wait for their surgery is something we’ve been keen to offer for some time. Having the consistency of supervision by a prehab specialist we hope will lead to a lower risk of complications post-transplant and improve quality of life both pre and post-operatively.”

The digital programmes and resources run will be specially developed to cater for the clinical and holistic needs of liver patients in collaboration with the hospital team.

The 12-month trial will be evaluated through standardised patient reported outcome measures and physical assessment scores.

Teleheath company QuestPrehab founder Professor Tara Rampalsaid: “Waiting for a liver transplant is an extremely anxious time for all patients. They face the uncertainty of when they will be called up for the transplant whilst also dealing with the consequences of advanced liver disease and the worry that their condition may deteriorate during this time.”

“Patients will receive a highly personalised programme based on four key areas – physical activity, anxiety management, diet advice and lifestyle modifications – with a goal of alleviating their level of anxiety and improving their liver frailty score.”