Rehabilitation experts including Dr. Jonathan H. Whiteson combine prehabilitation and rehabilitation to produce exceptional outcomes for transplant patients.
Photo: Karsten Moran
Heart or lung transplant operations make extraordinary demands on patients, both during and after surgery. In partnership with ٺƵ Transplant Institute, experts at Rusk Rehabilitation help patients prepare for their procedures—and make a full recovery.
From Prehabilitation to Rehabilitation
Many patients who receive heart or lung transplants have been weakened by years of chronic illness, reducing their ability to endure the stresses of surgery and its aftermath. All transplant candidates at ٺƵ are referred to the Joan and Joel Smilow Cardiac Prevention and Rehabilitation Center for evaluation of physical, metabolic, and emotional fitness. Since its inception in 1991, the center—the largest and most comprehensive program of its kind in the tristate area—has been at the forefront of managing cardiopulmonary disease.
If needed, the patient receives a course of prehabilitation—exercise and lifestyle modification—to boost his or her strength and stamina. “The healthier a patient is before surgery, the better they’ll do during the operation, during their hospital stay, and over the course of their recovery,” explains Jonathan H. Whiteson, MD, associate professor in the , vice chair for Rusk Rehabilitation clinical operations, and medical director of cardiac rehabilitation.
After transplant surgery, patients are mobilized as soon as possible—generally, while still in intensive care. Most are discharged to Rusk Rehabilitation for two to three weeks of inpatient rehabilitation, in which physical and occupational therapists treat patients daily to promote mobility and foster independent functioning. Three months of outpatient therapy typically follow, with a focus on increasing endurance; reducing shortness of breath and fatigue; improving cholesterol and blood sugar levels for heart transplant patients; facilitating weight loss; and instilling a heart-healthy lifestyle.
A Measurable Improvement in Outcomes
The efficacy of Rusk Rehabilitation’s approach is reflected in the exceptional outcomes reported by the Transplant Institute, which performed 31 heart transplants and 35 lung transplants in 2019. Thanks in part to this advanced model of pre- and postsurgical care, the median length of stay for heart transplant patients at ٺƵ was 14 days, compared with 16 days across the United States and 19 days in the New York metropolitan area; for lung transplant patients, median length of stay was 7 days at ٺƵ versus 18 days nationwide and 19 days throughout the region.
Most importantly, referral to Rusk Rehabilitation contributes to superior results in longer-term patient recovery and survivorship. The 1-year survival rate for heart transplant patients at ٺƵ was 100 percent—nearly 9 percentage points higher than the U.S. figure.
“The coordinated care that Rusk Rehabilitation provides has helped ٺƵ achieve national leadership in this challenging arena,” notes Dr. Whiteson. “But what’s most important is that we’re changing lives. We’re building patients up and helping get them back to their full role in society.”
