New digital “prehab” service for people waiting for a liver transplant

Posted on: 25th July 2024

A liver transplant is a major operation. To be on the transplant list, patients must be both sick enough to need a new liver and well enough to cope with the surgery.

The South West liver unit at University Hospitals Plymouth has now teamed up with telehealth company QuestPrehab to offer a digital “prehab” scheme. The year-long trial will give personalised support to people waiting for a transplant. Helping them to prepare physically and mentally for their surgery.

What is prehab?

Going into surgery as healthy as possible helps with recovery afterwards. Prehabilitation or “prehab” works with people waiting for an operation. It focuses on improving their general health and helping them to stay active.

Patients who have completed prehab are less likely to be readmitted to hospital. They report higher health related quality of life. And often return to work sooner than people who have not had prehab.

Digital prehab

The trial will work with 50 people in Devon, Cornwall and Somerset who are being assessed or listed for a liver transplant. Many people in these areas live a long way from the liver unit in Plymouth. So attending regular in person prehab sessions could be difficult.

QuestPrehab’s app aims to remove this barrier by allowing people to access a personalised programme from home.

We’re very excited to have the opportunity to expand much-needed support to our patients here in the south west,

Liver transplant patients face many challenges and to be able to provide a personalised prehab service while they wait for their surgery is something we’ve been keen to offer for some time. Having the consistency of supervision by a prehab specialist we hope will lead to a lower risk of complications post-transplant and improve quality of life both pre and post-operatively.

– Professor Matthew Cramp, Consultant Hepatologist at the South West Liver Unit, UHP.

Many people have to wait some time before a suitable liver is available. The digital prehab scheme will make use of this time to help patients prepare. They will be given diet advice and exercise classes.  And will be able to access support sessions over the phone or by video call. Any patients who do not have access to the equipment they need will be able to borrow this from the liver Unit.

Help with anxiety

The prehab scheme will also help patients cope with the anxiety that many feel while they are going through assessment or waiting for a donor liver.

Waiting for a liver transplant is an extremely anxious time for all patients. They face the uncertainty of when they will be called up for the transplant whilst also dealing with the consequences of advanced liver disease and the worry that their condition may deteriorate during this time.

Patients will receive a highly personalised programme based on four key areas – physical activity, anxiety management, diet advice and lifestyle modifications – with a goal of alleviating their level of anxiety and improving their liver frailty score.

– QuestPrehab founder Professor Tara Rampal.

The trial will look at the practicalities of delivering prehabilitation digitally. And at the impact it has on the quality of life of people waiting for a liver transplant. The hope is that this will lead to the scheme being expanded. So it can be offered to people with other liver conditions who may not yet be on the transplant list.