International Journal of Innovative Technologies in Social Science · Jul 22, 2026

PREHABILITATION IN PATIENTS AWAITING LIVER TRANSPLANTATION – A REVIEW OF CURRENT EVIDENCE

By Mruzek T, Marcysiak A, Mularczyk P et al.

End-stage liver disease (ESLD) is associated with significant metabolic disturbances, including chronic inflammation, hypercatabolism, and impaired protein synthesis, which lead to the development of sarcopenia and frailty. These conditions are common among patients qualified for liver transplantation and represent independent risk factors for waitlist mortality, postoperative complications, and prolonged hospitalization. Prehabilitation, defined as a multimodal intervention including physical training, nutritional optimization, and psychological support, aims to improve the patient’s physiological reserve prior to surgery. The aim of this study was a systematic evaluation of the available evidence regarding prehabilitation in liver transplant candidates, with particular emphasis on its impact on physical performance and clinical outcomes. Available data indicate that prehabilitation improves performance parameters such as VO₂peak and the 6-minute walk distance. However, its impact on hard clinical endpoints, including mortality and postoperative complications, remains inconclusive. Prehabilitation appears to be a safe and potentially beneficial intervention, particularly in frail patients; however, further high-quality studies are required.

doi.org/10.31435/ijitss.3(51).2026.5722 Open access Interventions