Exercise and organ transplantation.

Life-saving treatment of disease by organ transplantation has become increasingly important. Annually over 35,000 transplantations of vital organs are carried out world-wide and the demand for knowledge regarding exercise in daily life for transplant recipients is growing. The present review describes whole-body and organ reactions to both acute exercise and regular physical training in persons who have undergone heart, lung, liver, kidney, pancreas or bone marrow transplantation. In response to acute exercise, the majority of cardiovascular, hormonal and metabolic changes are maintained after transplantation. However, in heart transplant recipients organ denervation reduces the speed of heart rate increase in response to exercise. Furthermore, lack of sympathetic nerves to transplanted organs impairs the normal insulin and renin responses to exercise in pancreas and kidney transplant recipients, respectively. In contrast, surgical removal of sympathetic liver nerves does not inhibit hepatic glucose production during exercise, and denervation of the lungs does not impair the ability to increase ventilation during physical exertion. Most studies show that physical training results in an improved endurance and strength capacity in almost all groups of transplant recipients, which is of importance for their daily life. With a little precaution, organ transplant recipients can perform exercise and physical training and obtain effects comparable with those achieved in the healthy population of similar age.