EXERCISE AND DIET INTERVENTION AFTER LIVER TRANSPLANT

肝移植是治疗终末期肝功能衰竭的一种公认的治疗方法 与移植前相比， 然而，移植受者继续经历着严重的 身体功能受限，并经常报告症状 与肌肉无力和疲劳有关， 体重增加. 心血管风险也会增加。 通常患者 在医学上跟踪他们器官的功能， 注意力和没有干预措施，以改善身体 健身或尽量减少体重增加和心血管风险。 换句 移植受者运动训练增加身体功能 并且饮食改变导致改善的脂质分布。 没有这样的 已经在肝移植受者中进行了研究。 拟定研究 是一项针对肝移植受者的随机临床试验， 身体健康、生活质量和心血管风险的差异 两组之间：糖尿病护理UC）和运动干预 训练加饮食调整（XD）。 干预措施将启动 移植后3个月，将在3、6和12时进行检测 移植后几个月。 这项运动将个别规定， 每天在家里独立步行或骑自行车。 膳食干预 将基于国家胆固醇教育项目 以实现热量平衡为目标的建议， 体重在理想体重± 10%范围内。 两 将积极监测干预措施， 记录日志，定期电话随访和定期门诊。 主要结果指标为：1）身体健康指标：a） 通过最大摄氧量测量的心肺适能;肌肉 通过等速测试的峰值扭矩测量的强度;和身体 测量的身体组成（体脂百分比和瘦体重）， 双重X线吸收测定法; 2）生活质量/福祉， 使用基于医学结局研究的问卷进行测量 问卷;和3）使用算法的心血管风险指数 基于Fragrance数据。 此外，移植的临床措施 将监测功能和药物，以评估 干预措施。 数据分析技术将测试 干预以及确定几个测量的关系 生活质量/福祉的变量。 这项研究需要 证明运动和饮食干预对优化 身体健康和生活质量的改善 这可能是由于肝脏移植单独和减少 心血管疾病的风险。

Liver transplantation is an accepted therapy for end-stage liver failure and clearly increases physical functioning compared to pre transplant levels, however transplant recipients continue to experience significant limitations in physical functioning and frequently report symptoms related to muscle weakness and fatigue and are at risk for excessive weight gain. Cardiovascular risk is also elevated. Typically patients are followed medically for the functioning of their organ, however little attention and no interventions are incorporated to improve physical fitness or minimize weight gain and cardiovascular risk. In other transplant recipients exercise training increases physical functioning and dietary modification results in improved lipid profiles. No such study has been done in liver transplant recipients. The proposed study is a randomized clinical trial of liver transplant recipients to determine differences in physical fitness, quality of life and cardiovascular risk between groups: Usual Care UC) and an intervention of Exercise Training plus Diet Modification (XD). The interventions will be initiated 3 months after transplant and testing will be done at 3, 6 and 12 months post transplant. The exercise will be individually prescribed for daily independent walking or cycling at home. The dietary intervention will be based on the National Cholesterol Education Project Recommendations with the goal of achieving caloric balance to maintain body weight within ideal body weight plus/minus 10%. Both interventions will be aggressively monitored to maximize adherence using recording logs, regular phone follow-up and regular clinic visits. Primary outcome measures are: 1) measures of physical fitness: a) cardiorespiratory fitness as measured by maximal oxygen uptake; muscle strength as measured by peak torque by isokinetic testing; and body composition (body fat percentage and lean body mass) as measured by dual X-ray absorptiometry; 2) Quality of life/well-being which will be measured using questionnaire based on the Medical Outcomes Study questionnaire; and 3) Cardiovascular Risk Index using an algorithm based on Framingham data. Additionally, clinical measures of transplant function and medications will be monitored to assess the impact of the interventions. Data analysis techniques will test the effectiveness of the intervention as well as determine the relationship of several measured variables to quality of life/well-being. This study is needed to demonstrate the impact of exercise and diet interventions on optimizing physical fitness and quality of life over and above any improvements that may result from the liver transplant alone and to reduce cardiovascular risk following this surgical procedure.