PRehab tO PreparE Living Liver Donors for Enhanced Recovery (PROPELLER): A Feasibility Randomized Controlled Trial.

The recruitment rate for the feasibility RCT was 48%, with 30 of 63 eligible patients enrolled.

• 63 patients were deemed eligible at Toronto General Hospital
• 30 patients were enrolled, yielding a 48% enrollment rate
• Participants were randomized 2:1 to prehabilitation or usual care
• Mean age of participants was 42 ± 8 years and 67% were female

There were no intervention-related adverse events in the prehabilitation group.

• Safety was assessed as part of the primary feasibility outcome
• Adverse event monitoring was conducted across all components of the multimodal prehabilitation intervention
• The four components included exercise, nutrition support, psychological counselling, and peer mentor sessions

Attrition in the study was 33%.

• Retention was assessed as one of the primary feasibility outcomes alongside recruitment, adverse events, adherence, and healthcare provider engagement
• Attrition rate of 33% was observed across the study population
• Retention was measured from enrollment through postoperative follow-up at 4 and 12 weeks

Adherence to each component of the multimodal prehabilitation intervention was at least 75%.

• Adherence was ≥75% across each of the four components: exercise, nutrition support, psychological counselling, and peer mentor sessions
• Adherence was measured as part of the primary feasibility outcome
• Clinical, patient-reported, and physical fitness outcomes were collected at baseline, preoperatively, and at 4 and 12 weeks postoperatively

Qualitative interviews demonstrated participant satisfaction with the prehabilitation intervention and identified areas for improvement for a Phase III RCT.

• Qualitative interviews were used to assess feasibility and satisfaction with the intervention
• Interviews revealed both satisfaction with the current prehabilitation program and areas for improvement
• Healthcare provider engagement was also assessed as part of the primary feasibility outcome
• Findings from interviews will inform the design of the Phase III RCT

No prior study had examined the role of multimodal prehabilitation for living donor liver transplantation prior to this trial.

• The authors identified a gap in the literature regarding prehabilitation specifically for living liver donors (LLDs)
• Preserving health and quality of life are stated priorities of care for LLDs due to their altruistic contribution
• A feasibility study was identified as necessary prior to determining efficacy of prehabilitation in this population

The multimodal prehabilitation intervention comprised four components: exercise, nutrition support, psychological counselling, and peer mentor sessions.

• The peer mentor component specifically involved living liver donor peer mentor sessions
• Outcomes were collected at baseline, preoperatively, and at 4 and 12 weeks postoperatively
• The intervention was compared against usual care in a randomized 2:1 allocation
• The study was conducted at Toronto General Hospital and registered as NCT0543136