Telerehabilitation for frail cirrhotic patients awaiting liver transplant: A safe, effective strategy to improve outcomes

doi:10.4254/wjh.v17.i10.110856

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Oct 27, 2025 (publication date) through Oct 27, 2025

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World Journal of Hepatology

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1948-5182

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Clinical Trials Study

World J Hepatol. Oct 27, 2025; 17(10): 110856
Published online Oct 27, 2025. doi: 10.4254/wjh.v17.i10.110856

Telerehabilitation for frail cirrhotic patients awaiting liver transplant: A safe, effective strategy to improve outcomes

Thais Mellato Loschi, Melline D T A Baccan, Elaine C Pereira, Thaise D L C Dellabarba, Amanda P C S Boteon, Yuri L Boteon

Thais Mellato Loschi, Melline D T A Baccan, Elaine C Pereira, Thaise D L C Dellabarba, Amanda P C S Boteon, Transplant Centre, Hospital Israelita Albert Einstein, São Paulo 05652-900, Brazil

Thais Mellato Loschi, Yuri L Boteon, Instituto Israelita de Ensino e Pesquisa Albert Einstein, Faculdade Israelita de Ciências da Saúde Albert Einstein, São Paulo 05652-900, Brazil

Author contributions: Boteon YL, Boteon APCS and Loschi TM conceived the idea and designed the study. Boteon YL, Boteon APCS and Loschi TM performed the literature search; Loschi TM, Baccan MDTA, Pereira EC and Dellabarba TDLC performed the physiotherapy sessions and collected the data; Boteon YL, Boteon APCS and Loschi TM drafted and approved the final manuscript; Baccan MDTA, Pereira EC and Dellabarba TDLC reviewed the draft and approved the final manuscript. All authors contributed to editing and approved the final manuscript version.

Institutional review board statement: This study was reviewed and approved by the local Ethical Review Board (Hospital Israelita Albert Einstein CAAE number 40105420.7.0000.0071, opinion 4.982.351).

Clinical trial registration statement: This study has not been registered at https://clinicaltrials.gov.

Informed consent statement: All the individuals who participated in this study provided their written informed consent prior to study enrolment.

Conflict-of-interest statement: This research received no specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

CONSORT 2010 statement: The authors have read the CONSORT 2010 statement, and the manuscript was prepared and revised according to the CONSORT 2010 Statement.

Data sharing statement: No additional data are available.

Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/

Corresponding author: Yuri L Boteon, MD, PhD, FACS, Professor, Instituto Israelita de Ensino e Pesquisa Albert Einstein, Faculdade Israelita de Ciências da Saúde Albert Einstein, 627/701 Albert Einstein Avenue, São Paulo 05652-900, Brazil. yuri.boteon@einstein.br

Received: June 17, 2025
Revised: July 4, 2025
Accepted: September 17, 2025
Published online: October 27, 2025
Processing time: 132 Days and 20.2 Hours

Core Tip

Core Tip: This study demonstrates that a supervised 12-week telerehabilitation programme is safe, feasible, and effective in addressing frailty among cirrhotic patients awaiting liver transplantation. Adherent patients showed significant improvements in frailty scores (Liver Frailty Index), functional capacity (4-minute step test), and quality of life (36-Item Short Form Health Survey domains). These findings support the use of telerehabilitation as a practical strategy for pre-transplant optimisation in a high-risk, geographically dispersed population.