An attempt to assess the influence of primary disease on the results of therapeutic rehabilitation in an early post-operative period in orthotopic liver transplant recipients.
BACKGROUND
A retrospective analysis of the effects of early postoperative rehabilitation in patients undergoing orthotropic liver transplantation in correlation to the primary liver disease leading to transplantation.


METHODS
In between 2000 and 2003 in the Department of General, Transplant and Liver Surgery of the Medical University of Warsaw Central Teaching Hospital, 213 orthotropic liver transplants (OLT) were performed. Full rehabilitation records were available for 136 patients. For statistical analysis, patients were divided into 5 different groups representing different causes of primary liver insufficiency.


RESULTS
Achieved early rehabilitation results show that there was a strong correlation between the time at which physiotherapy was introduced and the ability to achieve a fully upright position in correlation to the primary cause of liver disease necessitating transplantation. The shown relationship is probably a direct effect of the time of disease progression before transplantation is required. The worst results were observed in group no. 4 where patients with acute and subacute liver insufficiencies were included, even though these patients had the lowest mean age.


CONCLUSIONS
1. The achieved results confirm the general compensation rule which states that the process of healing strongly depends on the time of disease development. 2. An analysis of the time, when rehabilitation was initiated and the ability of the patient to achieve a fully upright position in relation to the cause of liver insufficiency suggests that the reason for most delays is the inability to develop adequate compensational mechanisms as a result of rapid disease progression in cases of acute liver insufficiency.
Rongies
Witold
W
Department of Rehabilitation, Central Teaching Hospital in Warsaw, Poland. rongies@interia.pl
Stepniewska
Sylwia
S
Golińska
Barbara
B
Wojtaszek
Mikołaj
M
Dolecki
Włodzimierz
W
Lewandowska
Monika
M
Białoszewski
Dariusz
D
Krawczyk
Marek
M
D000208:Acute Disease; D006525:Hepatitis, Viral, Human / Q000601:surgery; D006801:Humans; D008104:Liver Cirrhosis, Alcoholic / Q000601:surgery; D008107:Liver Diseases / Q000145:classification* / Q000601:surgery*; D017093:Liver Failure / Q000601:surgery; D016031:Liver Transplantation / Q000502:physiology* / Q000534:rehabilitation*; D011184:Postoperative Period; D016896:Treatment Outcome