Prevention and rehabilitation after heart transplantation: A clinical consensus statement of the European Association of Preventive Cardiology, Heart Failure Association of the ESC, and the European Cardio Thoracic Transplant Association, a section of ESOT

Author:

Simonenko Maria1ORCID,Hansen Dominique23,Niebauer Josef4ORCID,Volterrani Maurizio5,Adamopoulos Stamatis6,Amarelli Cristiano7,Ambrosetti Marco8,Anker Stefan D9,Bayes-Genis Antonio10,Gal Tuvia Ben11,Bowen T Scott12,Cacciatore Francesco13,Caminiti Giuseppe5,Cavarretta Elena1415,Chioncel Ovidiu1617,Coats Andrew J S18,Cohen-Solal Alain19,D’Ascenzi Flavio20,de Pablo Zarzosa Carmen21,Gevaert Andreas B2223,Gustafsson Finn24,Kemps Hareld2526,Hill Loreena27,Jaarsma Tiny2829,Jankowska Ewa30,Joyce Emer3132,Krankel Nicolle33,Lainscak Mitja34,Lund Lars H35,Moura Brenda3637,Nytrøen Kari38,Osto Elena3940,Piepoli Massimo4142,Potena Luciano43,Rakisheva Amina4445,Rosano Giuseppe46,Savarese Gianluigi47,Seferovic Petar M48,Thompson David R27,Thum Thomas49,Van Craenenbroeck Emeline M2223

Affiliation:

1. Cardiopulmonary Exercise Test Research Department, Heart Transplantation Outpatient Department, V.A. Almazov National Medical Research Centre , St. Petersburg , Russia

2. REVAL and BIOMED Rehabilitation Research Center, Hasselt University , Hasselt , Belgium

3. Heart Centre Hasselt, Jessa Hospital , Hasselt , Belgium

4. University Institute of Sports Medicine, Prevention and Rehabilitation, Paracelsus Medical University , Salzburg , Austria

5. Cardio-Pulmonary Department, IRCCS San Raffaele Roma , Rome , Italy

6. Heart Failure and Heart Transplantation Unit, Onassis Cardiac Surgery Center , Athens , Greece

7. Department of Cardiac Surgery and Transplants, Monaldi Hospital , Azienda dei Colli, Naples , Italy

8. Cardiovascular Rehabilitation Unit, ASST Crema, Santa Marta Hospital , Rivolta d’Adda (CR) , Italy

9. Department of Cardiology (CVK), Berlin Institute of Health Center for Regenerative Therapies (BCRT), German Centre for Cardiovascular Research (DZHK) partner site Berlin, Charité Universitätsmedizin Berlin , Berlin , Germany

10. University Hospital Germans Trias and Pujol de Badalona , Badalona , Spain

11. Heart Failure Unit, Cardiology Department, Rabin Medical Center, Petah Tikva and Sackler, Faculty of Medicine, Tel Aviv University , Tel Aviv , Israel

12. School of Biomedical Sciences, Faculty of Biological Sciences, University of Leeds , Leeds , UK

13. Department of Translational Medicine, University of Naples ‘Federico II’ , Naples , Italy

14. Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome , Rome , Italy

15. Mediterranea Cardiocentro , Naples , Italy

16. Emergency Institute for Cardiovascular Diseases ‘Prof. C.C. Iliescu’ , Bucharest , Romania

17. University of Medicine Carol Davila , Bucharest , Romania

18. Heart Research Institute , Sydney, NSW , Australia

19. Cardiology Department, University of Paris , INSERM UMRS-942, Hopital Lariboisiere, AP-HP, Paris , France

20. Division of Cardiology, Department of Medical Biotechnologies, University of Siena , Siena , Italy

21. Department of Cardiology, Ramón y Cajal University Hospital , Madrid , Spain

22. Research Group Cardiovascular Diseases, GENCOR, University of Antwerp , Antwerp , Belgium

23. Department of Cardiology, Antwerp University Hospital , Edegem , Belgium

24. Department of Cardiology, Rigshospitalet, University of Copenhagen , Copenhagen , Denmark

25. Department of Cardiology, Maxima Medical Centre , Eindhoven , The Netherlands

26. Department of Industrial Design, Eindhoven University of Technology , Eindhoven , The Netherlands

27. School of Nursing and Midwifery, Queen’s University Belfast , Belfast , UK

28. Department of Health, Medicine and Caring Science, Linköping University , Linköping , Sweden

29. Julius Center, University Medical Center Utrecht , Utrecht , The Netherlands

30. Wroclaw Medical University , Wroclaw , Poland

31. Department of Cardiology, Mater University Hospital , Dublin , Ireland

32. School of Medicine, University College Dublin , Dublin , Ireland

33. Universitätsmedizin Berlin Campus Benjamin Franklin Klinik für Kardiologie Charite , Berlin , Germany

34. General Hospital Murska Sobota , Murska Sobota , Slovenia

35. Department of Medicine, Karolinska Institutet and Heart and Vascular Theme, Karolinska University Hospital , Stockholm , Sweden

36. Armed Forces Hospital , Porto , Portugal

37. Centre for Health Technologies and Services Research, Faculty of Medicine of University of Porto , Porto , Portugal

38. Department of Cardiology, Oslo University Hospital Rikshospitalet , Oslo , Norway

39. Division of Physiology and Pathophysiology, Otto Loewi Research Center for Vascular Biology, Immunology and Inflammation, Medical University of Graz , Graz , Austria

40. Vetsuisse Faculty, University of Zurich , Zurich , Switzerland

41. Dipartimento Scienze Biomediche per la Salute, Universita’ Degli Studi di Milan , Milan , Italy

42. Cardiologia Universitaria, IRCCS Policlinico San Donato , Milan , Italy

43. University Hospital of Bologna , Bologna , Italy

44. Department of Cardiology, Scientific Institution of Cardiology and Internal Diseases , Almaty , Kazakhstan

45. Department of Cardiology, Kapshagai City Hospital , Almaty , Kazakhstan

46. St. George’s Hospital NHS Trust University of London , London , UK

47. Division of Cardiology, Department of Medicine, Karolinska Institutet , Stockholm , Sweden

48. Faculty of Medicine and Heart Failure Center, University of Belgrade, Belgrade University Medical Center , Belgrade , Serbia

49. Institute of Molecular and Translational Therapeutic Strategies (IMTTS), Hannover Medical School and Fraunhofer Institute for Toxicology and Experimental Research , Hannover , Germany

Abstract

Abstract Little is known either about either physical activity patterns, or other lifestyle-related prevention measures in heart transplantation (HTx) recipients. The history of HTx started more than 50 years ago but there are still no guidelines or position papers highlighting the features of prevention and rehabilitation after HTx. The aims of this scientific statement are (i) to explain the importance of prevention and rehabilitation after HTx, and (ii) to promote the factors (modifiable/non-modifiable) that should be addressed after HTx to improve patients’ physical capacity, quality of life and survival. All HTx team members have their role to play in the care of these patients and multidisciplinary prevention and rehabilitation programmes designed for transplant recipients. HTx recipients are clearly not healthy disease-free subjects yet they also significantly differ from heart failure patients or those who are supported with mechanical circulatory support. Therefore, prevention and rehabilitation after HTx both need to be specifically tailored to this patient population and be multidisciplinary in nature. Prevention and rehabilitation programmes should be initiated early after HTx and continued during the entire post-transplant journey. This clinical consensus

Publisher

Oxford University Press (OUP)

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