*Purpose: Sarcopenia and frailty are independent predictors of mortality in cirrhotic patients; increased access to physical therapy (PT) and registered dietician (RD) services have the potential to improve patients’ performance status.

*Methods: Starting in January 2018, all liver transplant (LT) candidates at our center were screened for frailty using the Fried Index. Patients identified as frail or pre-frail were given a personalized PT plan and followed by a dedicated LT RD who provided dietary guidance and treatment as necessary. Patients’ frailty scores were reassessed at least every three months to identify new candidates in need of intervention and monitor improvement. Patients continued the program until transplant, delisting or waitlist mortality and had at least 3 months of follow-up. The Wilcoxon signed rank test was used to compare changes in frailty score pre- and post-intervention.

*Results: Ninety-nine patients were determined to be pre-frail (n=50) or frail (n=49) at LT evaluation and enrolled in the program. Patient demographics were similar between groups, though there were a greater proportion of frail NASH patients and more HCC diagnosis in the pre-frail group (table 1). Nearly half of enrolled pre-frail pts (46%) and the majority of frail patients (61%) made improvements in their frailty score at last follow up. On the whole, patients in the intervention had a median one point decrease in their Fried score from baseline (p<0.001).

*Conclusions: Access to a physical therapy and nutrition intervention can improve functional status even in the setting of advanced liver disease.

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