Inpatient Prehab Helps Frail Heart Transplant Candidates Qualify — SkimNews
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- Radha Gopalan, a heart transplant cardiologist at Banner–University Medical Center Phoenix, launched an inpatient cardiac prehab program in 2023 for waitlisted patients admitted with worsening heart failure, abnormal heart rhythms, or coronary artery disease.
- Across 45 patients who started too frail for immediate transplant, 56% in year one and 62% in year two met listing criteria after prehab, with Gopalan reporting no deaths, complications, or falls.
- Gopalan and his team presented results in April at the International Society of Heart and Lung Transplantation meeting in Toronto.
- Average frailty scores fell from 2.5 to 1.5 out of 5, dropping patients below the program's 3-point cutoff that would otherwise flag them as too high-risk for post-operative complications.
- The gym uses recumbent and arm-only bicycles — a treadmill was deliberately excluded to prevent falls in this population.
- Gopalan cited studies showing one day of bed rest requires three days to recover lost muscle strength, meaning a 10-day hospital stay can take 30 days to reverse.
- The program runs on philanthropic funding secured through the hospital's foundation, with the hospital providing telemetry-floor space; Gopalan said NIH funding would require collecting more data first.
Why it matters: Roughly 38–44% of hospitalized heart transplant candidates still failed to qualify even after prehab, per the program's own results — but for the majority who did improve, the intervention offered a route around the hospital-bed deconditioning that otherwise permanently disqualifies patients from lifesaving transplant surgery. The reliance on philanthropic rather than NIH funding, combined with a sample of just 45 patients, limits how quickly this model can spread.
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