BACKGROUND: Functional impairment is common among patients with chronic liver disease (CLD) and improvement is expected following liver transplantation (LT). The 6-minute walk distance (6MWD) is an objective measure of functional performance and predicts survival in decompensated CLD. However, no studies have determined whether the 6MWD improves after LT. AIM: To compare 6MWD between LT recipients over time compared to healthy controls (HC) and CLD patients. METHODS: 70 ambulatory participants (40 CLD, 30 LT) had 6MWD measured using a standard protocol. 6MWD data from 107 age and sex-matched HC were used as comparators. Data were analyzed using Chi-square, ANOVA, and Pearson coefficients. Logistic regression assessed characteristics associated with 6MWD. RESULTS: Participant age was 57.6 ± 10.4 years and the sample was equally distributed by sex (43.6% female), race (70.5% white) and calculated MELD score (6.35 ± 4.35). LT recipient 6MWD was 402.7 ± 129.3 meters (m) at 42 ± 12.1 days post-LT. By 85.9 ± 18.0 days post-LT, recipient 6MWD had not significantly improved (423.5 ± 116.1 m, p=0.76). LT recipient 6MWD was significantly worse than in the CLD (512.4 ± 91.3 m) and HC (482.0 ± 110.7 m, p<0.001 for both) groups. LT recipient 6MWD showed a moderate direct correlation with male gender (r=0.38, p=0.003) and an inverse correlation with age (r=-0.28, p=0.03) and diabetes status (r=-0.37, p=0.004). Diabetes remained associated with 6MWD even after adjustment for age and gender (OR=0.993, p<0.05). LT recipient 6MWD was not related to body mass index, history of cardiovascular disease, smoking status, MELD score, etiology of liver disease, hepatocellular carcinoma, creatinine, ALT, graft rejection or re-hospitalization. CONCLUSIONS: The 6MWD is notably lower in patients up to 3 months following LT as compared to HC and CLD patients. Among LT recipients, diabetes is associated with poorer 6-minute walk performance. Further study to determine if and when the 6MWD approaches that of HC following LT and to help identify suitable patients for more intense exercise programs is ongoing.

« Back to 2013 American Transplant Congress