Consensus Recommendations for a Research Agenda in Exercise in Solid Organ Transplantation

Department of Physical Therapy, University of Toronto, Toronto, ON, Canada Sunnybrook Research Institute, Sunnybrook Health Sciences Centre St John’s Rehab Program, Toronto, ON, Canada Toronto Lung Transplant Program – University Health Network, Toronto, ON, Canada Department of Medicine, University of Toronto, Toronto, ON, Canada Department of Pediatrics and Child Health, Division of Nephrology, University of Manitoba, Winnipeg, MB, Canada Piedmont Transplant Institute, Atlanta, GA Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada Mazankowski Alberta Heart Institute, Edmonton, AB, Canada Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC Multi-Organ Transplant Program, London Health Sciences Centre, London, ON, Canada Department of Paediatrics, University of Toronto, Toronto, ON, Canada Division of Gastroenterology, Hepatology and Nutrition, Hospital for Sick Children, Toronto, ON, Canada Department of Pediatrics, Division of Pediatric Respiratory Medicine, McGill University Health Centre, Montréal, QC, Canada Quebec Lung Transplant Program, Centre Hospitalier de l’Université de Montréal, Montréal, QC, Canada Toronto Rehabilitation Institute University Health Network, Cardiovascular Prevention and Rehabilitation Program, Toronto, ON, Canada Department of Surgery, University of Michigan, Ann Arbor, MI Department of Health Management & Policy, University of Michigan, Ann Arbor, MI Corresponding author: Sunita Mathur, sunita.mathur@utoronto.ca Sunita Mathur and Tania Janaudis-Ferreira are co-first authors. With improved survival rates in solid organ transplantation there has been an increased focus on long-term outcomes following transplant, including physical function, health-related quality-of-life and cardiovascular mortality. Exercise training has the potential to affect these outcomes, however, research on the optimal timing, type, dose of exercise,modeof delivery and relevant outcomes is limited. This article provides a summary of a 2-day meeting held in April 2013 (Toronto, Canada) in which a multi-disciplinary group of clinicians, researchers, administrators and patient representatives engaged in knowledge exchange and discussion of key issues in exercise in solid organ transplant (SOT). The outcomes from the meeting were the development of top research priorities and a research agenda for exercise in SOT, which included the need for larger scale, multi-center intervention studies, development of standardized outcomes for physical function and surrogate measures for clinical trials, examining novel modes of exercise delivery and novel outcomes from exercise training studies such as immunity, infection, cognition and economic outcomes. The development and dissemination of ‘‘expert consensus guidelines,’’ synthesizing both the best available evidence and expert opinion was prioritized as a key step toward improving program delivery.