Effect of a transfer- and ambulation-focused early mobilization protocol on functional capacity after kidney transplantation: a randomized controlled trial.

BACKGROUND

Early mobilization is recommended to improve postoperative recovery, yet implementation after kidney transplantation is often delayed or limited.

OBJECTIVES

To determine whether a transfer- and ambulation-focused early mobilization protocol improves early postoperative exercise capacity and mobilization in kidney transplant recipients(KTRs), and to evaluate its safety and feasibility.

METHODS

Single-center, randomized, parallel-group controlled trial conducted at West China Hospital, Sichuan University (Chengdu, China). Fifty-four adults undergoing kidney transplantation were randomized 1:1 postoperatively to usual care (control group) or usual care plus an early transfer- and ambulation-focused mobilization protocol (early mobilization group, EMG). The primary outcome was the 6-minute walk distance (6-MWD) on postoperative day(POD) 7; secondary outcomes included 6-MWD change from baseline, grip strength, grip strength change from baseline, laboratory indices, prespecified safety and feasibility endpoints, postoperative complications, and hospital length of stay.

RESULTS

Baseline characteristics were comparable between groups. Compared with CG, EMG achieved shorter bed rest time, better 6-MWD (with a smaller postoperative decline from baseline where available), and lower white blood cell (WBC) count on POD7 (all p < 0.05). No participant in EMG was graded as "unable to complete" the mobilization protocol, and no protocol-related adverse events were observed.

CONCLUSIONS

A transfer- and ambulation-focused early mobilization protocol improved early postoperative functional capacity and mobilization in KTRs and appeared safe and feasible.

TRIAL REGISTRATION: http://www.chictr.org.cn ChiCTR2400086546(07/04/2024).