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When transplant candidates become frail, doctors often worry that they are too weak to survive transplantation. But according to a new study from Northwestern Medicine and the University of Pittsburgh, frailty can be significantly improved with the right personalized, physician-led fitness program.

In the study, more than 350 liver transplant candidates participated in a highly individualized workout and nutrition program. Nearly two-thirds of patients who attended at least three program visits lowered their frailty score by an average of nearly 0.4 points—a number that turned out to be a game changer.

Patients whose score improved by 0.4 points or more had a roughly 50% lower risk of dying while waiting for a transplant.

"It doesn't matter how severe their disease is," said study senior author Dr. Andres Duarte-Rojo, a professor in the divisions of Gastroenterology and Hepatology and Organ Transplantation at Northwestern University Feinberg School of Medicine. "If they exercise and do what we ask them to do, they see a major improvement in their fitness and reduce their mortality risk before transplantation."

The study was published in the journal Clinical Gastroenterology and Hepatology.

According to Duarte-Rojo, only about 10 transplant centers worldwide (including at Northwestern and Pittsburgh) offer patients this personalized fitness program, called prehabilitation.

In the study, patients underwent tests to assess strength and nutritional needs as soon as they were referred to the transplantation center.

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