Characterizing Adult Rehabilitation Programs for Solid Organ Transplant Candidates and Recipients across Canada

Sahar Sohrabipour^1,2Nicholas Bourgeois^3,4Sunita Mathur⁵Tania Janaudis-Ferreira⁶Sherrie Logan⁷Lisa Wickerson^2,7,8Dmitry Rozenberg^1,2,7*

• ¹University of Toronto Temerty Faculty of Medicine, Toronto, Canada
• ²Division of Respirology, Toronto Lung Transplant Program, Ajmera Transplant Centre, Toronto General Hospital, University Health Network, Toronto, Canada
• ³Centre Hospitalier de l'Universite de Montreal, Montreal, Canada
• ⁴School of Rehabilitation, Universite de Montreal, Montreal, Canada
• ⁵Queen's University School of Rehabilitation Therapy, Kingston, Canada
• ⁶Research Institute, McGill University, Montreal, Canada
• ⁷Canadian Donation and Transplantation Research Program, Edmonton, Canada
• ⁸University of Toronto Department of Physical Therapy, Toronto, Canada

Introduction: Rehabilitation is integral for solid organ transplant (SOT) candidates and recipients, and aims to build physical capacity for surgery, facilitate post-operative recovery, and mitigate long-term complications. Prior to the COVID-19 era, in-person programs were the primary delivery model in Canadian SOT rehabilitation programs, but there are several knowledge gaps with the current delivery models. The aims of this study were to: 1) assess the characteristics and current practices of SOT rehabilitation programs in Canada, and 2) identify key facilitators and barriers to providing rehabilitation for the SOT population. Methods: An electronic survey was administered to 17 adult Canadian SOT rehabilitation programs utilizing REDCap in April 2024. The survey examined types of exercise training and supervision practices, clinical outcome measures, delivery models, safety considerations, facilitators, and barriers. Survey measures were summarized using descriptive statistics. Results: The response rate was 59% (10/17). Post COVID-19, there has been a shift in program delivery, with majority (60%) of SOT rehabilitation programs now using a hybrid approach comprised of both in-person and virtual components. There is heterogeneity among programs with respect to clinical assessments, safety measures, and virtual rehabilitation platforms. The most common barriers were limitations in funding and healthcare personnel. Conclusion: This study provides a better understanding of the current landscape and variability of SOT rehabilitation programs. Most programs have transitioned to hybrid models post-COVID-19, which may facilitate greater access. Future research can leverage findings from this survey to optimize SOT rehabilitation programs and improve clinical outcomes.