Nazir A, Rachmaniar S, Nurhalizah HA. Pulmonary rehabilitation in lung transplantation: Its effects on pulmonary function, physical fitness, and quality of life. World J Transplant 2026; 16(2): 119752 [DOI: 10.5500/wjt.v16.i2.119752]
Corresponding Author of This Article
Arnengsih Nazir, MD, PhD, Academic Fellow, Assistant Professor, Department of Physical and Rehabilitation Medicine, Faculty of Medicine, Universitas Padjadjaran, Dr. Hasan Sadikin General Hospital, No. 38 Jalan Pasteur, Bandung 40161, West Java, Indonesia. arnengsih@unpad.ac.id
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Cardiac & Cardiovascular Systems
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review-article
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Nazir A, Rachmaniar S, Nurhalizah HA. Pulmonary rehabilitation in lung transplantation: Its effects on pulmonary function, physical fitness, and quality of life. World J Transplant 2026; 16(2): 119752 [DOI: 10.5500/wjt.v16.i2.119752]
World J Transplant. Jun 18, 2026; 16(2): 119752 Published online Jun 18, 2026. doi: 10.5500/wjt.v16.i2.119752
Pulmonary rehabilitation in lung transplantation: Its effects on pulmonary function, physical fitness, and quality of life
Arnengsih Nazir, Santi Rachmaniar, Hana Athaya Nurhalizah
Arnengsih Nazir, Department of Physical and Rehabilitation Medicine, Faculty of Medicine, Universitas Padjadjaran, Dr. Hasan Sadikin General Hospital, Bandung 40161, West Java, Indonesia
Santi Rachmaniar, Department of Emergency, Rama Hadi Hospital, Purwakarta 41181, West Java, Indonesia
Hana Athaya Nurhalizah, Faculty of Medicine, Universitas Mataram, Mataram 83121, West Nusa Tenggara, Indonesia
Author contributions: Nazir A conceived, designed the study, and interpreted the data; Nazir A, Rachmaniar S, Nurhalizah HA performed the literature search and drafted the manuscript. All authors have read and approved the final manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Corresponding author: Arnengsih Nazir, MD, PhD, Academic Fellow, Assistant Professor, Department of Physical and Rehabilitation Medicine, Faculty of Medicine, Universitas Padjadjaran, Dr. Hasan Sadikin General Hospital, No. 38 Jalan Pasteur, Bandung 40161, West Java, Indonesia. arnengsih@unpad.ac.id
Received: February 5, 2026 Revised: March 9, 2026 Accepted: April 17, 2026 Published online: June 18, 2026 Processing time: 114 Days and 2.4 Hours
Abstract
Lung transplantation (LTx) is the definitive therapy for patients with end-stage lung disease and improves survival. However, many recipients continue to experience exercise intolerance, reduced physical capacity, and limitations in daily activities despite improved postoperative lung function. These impairments are multifactorial and closely associated with quality of life (QoL) and long-term outcomes. Pulmonary rehabilitation (PR) is a multidisciplinary intervention aimed at improving exercise capacity, physical fitness, and QoL and has demonstrated benefits across various chronic lung diseases. This narrative review synthesizes current evidence on PR in LTx recipients. A literature review was conducted to summarize PR program characteristics, safety, and reported outcomes across lung function, functional capacity, muscle fitness, activity and participation, and QoL, considering heterogeneity in study design and intervention protocols. Across the reviewed studies, PR participation was consistently associated with improvements in cardiorespiratory fitness, muscle strength, functional capacity, and QoL. In contrast, changes in spirometric parameters were generally modest. Functional improvements appear to be largely mediated by peripheral adaptations, including enhanced oxygen utilization and neuromuscular performance. These findings highlight the potential role of PR as an important component of short- and long-term management in LTx recipients, particularly during pre-transplant conditioning and post-transplant functional recovery phases.
Core Tip: Lung transplantation (LTx) improves survival in end-stage lung disease, yet many recipients experience persistent exercise intolerance despite adequate graft function. This review highlights pulmonary rehabilitation (PR) as a safe and effective intervention throughout LTx care. PR programs, typically combining aerobic and resistance training with education, are associated with minimal adverse events. Evidence demonstrates improvements in cardiorespiratory fitness, muscular fitness, and quality of life, while changes in lung function are modest. These benefits are driven by peripheral physiological adaptations, including enhanced muscle oxidative capacity and neuromuscular efficiency. PR represents a fundamental strategy to optimize functional recovery in LTx recipients.
