Cardiologists at Banner–University Medical Center Phoenix have developed an inpatient prehabilitation program designed to address a critical problem in transplant care: patients waiting for heart transplants often become weaker during hospitalization, risking disqualification for the procedure. The program was created after cardiologist Radha Gopalan observed patients losing muscle strength and function during extended hospital stays, jeopardizing their chances of receiving a transplant.
The program targets patients on the transplant waitlist who are admitted to the hospital due to worsening heart failure, abnormal heart rhythms, or coronary artery disease. Rather than remaining bedbound, these patients participate in structured exercise sessions designed to maintain and improve their physical conditioning. The program uses specialized equipment including recumbent bicycles, sit-down bicycles, and arm bicycles, while intentionally excluding treadmills to prevent fall risks among vulnerable patients.
Testing began in 2023, with results presented at the International Society of Heart and Lung Transplantation meeting in April. During the two-year evaluation period, 56 percent of participants in the first year and 62 percent in the second year met transplant listing criteria following the program, with no reported adverse events including deaths, complications, or falls. Participants showed improvement in frailty scores, starting at an average of 2.5 out of 5 and improving to 1.5, bringing them below the transplant program’s threshold of 3.
Gopalan emphasizes that the initiative addresses a significant gap in care, noting that research demonstrates the stronger patients are at the time of surgery, the better their postoperative outcomes. The program was funded through philanthropic sources, with the hospital providing space on one of its telemetry floors. The preliminary results suggest the approach is both safe and effective in improving patients’ physical conditioning before transplant surgery.
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