Therapeutic perceptions in management of transplant athletes at transplant games

Supporting transplant athletes: perspectives on delivery of a sports performance and well-being service at the British Transplant Games

Evidence suggests that engaging in physical activity improves the mental and physical health of transplant recipients. An opportunity to be more active could be participating in the national and international network of Transplant Games. Although the literature on motivations for and the experience of taking part in the Games is available, little is known about what role applied practitioners, specifically sport and exercise psychologists could play as transplant recipients prepare and compete. This paper offers perspectives on the provision of a sports performance well-being service delivered at the British Transplant Games. The paper consists of several sections. The first offers background and how the service came into being. The second provides details of the model and philosophy that underpinned the service delivery. The third includes the trainee and exercise practitioner's casework and the challenges therein. Informed by the team's reflections and post-games survey the final section proposes recommendations for future applied sport and exercise services at this unique event.

An initial exploration of fatigue as a predictor of quality of life in transplant athletes competing at national and international events

Supporting organ transplant recipients' quality of life after surgery continues to be of interest to health researchers and applied practitioners. However, literature and guidance on the factors linked to quality of life in transplant recipient athletes remains underreported. This study aimed to identify significant predictors of quality of life in an international sample of organ transplant recipient athletes (N = 99, Mage = 53 ± 14). Adopting a cross-sectional design, we collected the study data during the 2019 World Transplant Games which consisted of demographic items, health, and physical activity-related measures (i.e., task and ego orientation, fatigue severity, assessment of physical activity, physical activity enjoyment). Predictor variables were summarised into three categories: demographic factors, sport-related factors, and levels of fatigue with physical and mental quality of life functioning as the outcome variables. Hierarchical regression analyses exposed fatigue to exert a significant negative influence on both mental and physical quality of life perceptions explaining 49% and 64% of the variance in these variables respectively. Routine measurement and monitoring of transplant athletes' level of fatigue in sport settings are recommended due to the negative bearing on quality of life that may be a potential barrier to sport participation and enjoyment.

Characteristics of transplant athletes competing at national and international transplant games

Objective

To describe the characteristics of athletes with solid-organ transplants (TxA) attending the British and World Transplant Games.

Methods

220 TxA completed an online survey to explore transplant history, medications, training advice and support and limitations to training.

Results

TxA were predominantly caucasian, male, kidney recipients in their mid-forties and approximately 11 years post-transplant. The majority of TxA took some form of medication (immunosuppressants 88%, steroids 47%, antihypertensives 47%, statins 28%, antiplatelets 26%, antibiotics/antivirals/antifungals 20%). Stem cell recipients were least likely to require medication. Post-transplant complications were experienced by 40% of TxA, with 53% of these being rejection. Although over half the participants (57%) initially received exercise or training advice post-transplant, only 34% of these received this from their consultants or immediate medical team. Only 1% had been specifically directed towards transplant sport. Half of the TxA (53%) perceived there were limitations preventing them from performing at their potential, 45% considered they did not recover from training as well as non-TxA while 29% felt they trained equally to non-Tx’s. Only 6% considered medication impaired training. TxA competed for a range of reasons from social and health benefits to winning medals.

Conclusions

TxA compete at the British and World Transplant Games for a diverse range of reasons. Athletes manage a range of medications with a range of exercise and health experiences pre-transplant. TxA face a lack of both general and specific exercise training and recovery guidance. The individuality of each TxA‘s background should be considered and is likely reflected in their exercise capacity and goals.