Rehabilitation after heart transplantation in Slovakia during the hospitalization phase

Abstract

Starting point: Heart transplantation (HTx) is a key therapeutic option for carefully selected patients with end-stage heart failure. As the number of transplant recipients increases, the focus is shifting from mere survival towards functional recovery, independence and quality of life, all of which are strongly influenced by postoperative rehabilitation. The aim of this study was to characterise the real  rehabilitation after HTx in Slovakia.

Group: A prospective clinical pilot study included 10 consecutive patients after orthotopic HTx (mean age 54.2 years; 8 men, 2 women) hospitalised in a Slovak tertiary cardiac centre. All patients completed the full inpatient physiotherapy programme until hospital discharge.

Methods: Physiotherapy records were analysed for time to extubation, first active sitting, standing and walking, length of stay, early postoperative complications and functional status at discharge (walking distance and stair climbing ability). A structured multi-phase physiotherapy protocol was used, ranging from respiratory physiotherapy and in-bed mobilisation to corridor and stair walking. Data were evaluated using descriptive statistics.

Results: Mean time to extubation was 4.4 days, to first sitting 5.8 days, to standing 7.8 days and to walking 11.6 days. At discharge, the mean corridor walking distance was 247 m; 90% of patients were able to walk independently and 70% could climb stairs. Complications (delayed extubation, arrhythmia, mild bleeding, transient delirium) were manageable and did not require interruption of rehabilitation.

Conclusions: The structured physiotherapy protocol after HTx used in this Slovak centre proved feasible, safe and effective in restoring functional mobility during the index hospitalisation. Systematic documentation of these outcomes represents an important step towards further improvement and harmonisation of post-HTx rehabilitation practice in Slovakia.