Preoperative rehabilitation, also known as ‘prehabilitation’ or ‘prehab’, aims to make patients as fit as possible before undergoing surgery. This project will develop a programme for patients who are on the waiting list for a kidney transplant. The researchers in this study will investigate the effects of prehab on general fitness and quality of life, mortality and complications in patients, both while they are still on the waiting list and after the transplant surgery. Dr Coby Annema, researcher at the Department of Nursing Science at the UMCG, is leading the study.
Patients who have to undergo kidney transplant surgery need to be in a good mental and physical condition in order to be able to endure the stress of transplant surgery and to enhance recovery after the transplant. However, these patients’ fitness is often affected by their kidney disease or dialyses. Preoperative rehabilitation has shown promising results in other patient groups and may also be beneficial for patients who are waiting for a kidney transplant. Prehab focuses on effecting changes in lifestyle and consists of physical training, nutritional advice and stress reduction. Offering these components before surgery increases the likelihood of patients permanently adopting a healthier lifestyle.
Preoperative rehabilitation programmes have not yet been applied to many transplant patients. Therefore, little is known about the effects of prehab in this patient group. . The idea behind the current study is that a prehabilitation programme will increase the general fitness of individual kidney patients, thereby helping them to cope with the stress surrounding surgery and achieve better results both before and after the transplant operation.
This project will develop a preoperative rehabilitation programme that is acceptable and feasible for kidney patients on the waiting list. The programme can be tailored to their individual needs and personal circumstances. Subsequently, the researchers will study the effects of the programme.
Mariette Kraayvanger, Dialysis and Transplant programme manager at the Dutch Kidney Foundation, is very enthusiastic about the programme: ‘The PreCareTx study focuses on prehabilitation, a form of rehabilitation that precedes transplant surgery. We believe that this may greatly benefit the general fitness of patients and speed up their recovery after the operation. Evaluations by patient panels support this idea. This is why we have decided to fund this project.’
The Health Sciences, Nephrology and Rehabilitation departments and the prehabilitation working group at the UMCG are collaborating in this project. The results of this study are expected to be published in four years.
The UMCG finds it very important to pay attention to lifestyle. For this reason, it initiated the Groningen Lifestyle Intervention Model (GLIM) this year, a model that aims to integrate lifestyle aspects in treatments. GLIM includes prehabilitation (making patients fitter before surgery) as well as permanent lifestyle guidance (during treatment and recovery). GLIM forms the basis for research and teaching in the field of lifestyle medicine. Four focus projects will start in 2021 in the departments of Oral & Maxillofacial Surgery, Hepato-Pancreato-Biliary Surgery, Plastic Surgery and the Groningen Transplant Centre, in close collaboration with the Centre for Rehabilitation. GLIM is part of the UMCG theme of healthy ageing in healthcare.
