Exercise Aids Transplant Patients

Monday, August 28th 2000, 12:00 am
By: News On 6

WASHINGTON (AP) — Exercise is good for your organs, even if the organs originally were someone else's.

``It's beneficial for a lot of reasons — to play basketball, or go back to work, or just live your life,'' said NBA All-Star forward Sean Elliott, who has a kidney transplanted from his brother, Noel.

Elliott had developed a progressive disease, focal segmental glomerular sclerosis, which reduces the kidneys' ability to filter the body's waste products. ``I started retaining a ton of water,'' he said. ``I lost my appetite. I became fatigued and started lying in bed a lot.''

On Aug. 16, 1999, Elliott had the transplant that let him start rebuilding his career and his life. ``A month out of surgery, I felt great — but extremely out of shape for me. It took me seven months to make it back to playing the game of basketball.''

Elliott is the first professional athlete to return to a sport after receiving an organ transplant. But his return to exercise after a transplant is not unusual. Doctors commonly recommend physical activity for patients with transplants.

A study in The New England Journal of Medicine in January 1999 found that heart transplant patients who did aerobic training gained greater endurance after six months, compared with patients who did not take part in the exercise program. Researchers at the University of California at Los Angeles concluded ``exercise training increases the capacity for physical work.''

Other studies have found similar benefits for patients with other transplants. For instance, an Austrian study published in 1998 in the American College of Chest Physicians' journal, Chest, found that stationary bike training improved the performance of lung transplant recipients.

Transplantees these days are not only encouraged to exercise, they are encouraged to compete. They even have their own version of the Olympics, the World Transplant Games, open to people with a functioning organ transplant.

Leading up to the world games, which will be held in 2001, were this year's U.S. games, organized by the National Kidney Foundation. They were held in June at Disney's Wide World of Sports Complex in Orlando, Fla., with Elliott as the official leading celebrity.

Nonetheless, transplantees have special needs in exercise. Chief among them is a greater need to stay hydrated. The requirement is partly a response to the drugs the patients take to suppress their immune systems, so their own bodies don't reject the donated organs, said Dr. Sharon Hunt, a heart transplant cardiologist at Stanford University. ``They all have a mild compromise in kidney function,'' she said.

``I drink about a gallon of water a day, at least,'' Elliott said.

Heart transplant patients may never reach the exercise ability of similar people who have their own hearts, although the difference might not be noticeable except to an elite athlete, Hunt said. ``They can't quite run the same marathon, but I'm guessing 80 percent,'' she said.

Transplanted hearts don't function quite the same to exercise, Hunt said. They don't immediately respond to stress by beating faster, because nerve connections needed to do this are not there, she said. Instead, the heart responds initially by contracting harder to pump blood, and starts to beat faster after a few minutes in response to higher levels of the hormone adrenaline, she said.

Other transplantees should have no such limitations on their performance, said Dr. Lew Teperman, director of transplantation at New York University. But the patients may have lingering problems from the disease that forced them to get the transplant, he said. For instance, former diabetics with a transplanted pancreas may have compromised hearts or blood vessels from the diabetes, he said.

However, people should not see transplant patients as any less able than people with all their original organs, said Corinne Carson, a 29-year-old Washington woman who received a liver transplant in 1994. In the season after the operation, Carson played basketball at Marymount University in suburban Virginia.

Carson tried out for the Women's National Basketball Association in 1997. But she didn't make the WNBA cut, and she suspects officials' perception of her health was a reason why. ``I had a couple of coaches tell me that if I get on someone's team, you are going to raise insurance prices,'' she said. ``They don't understand I have no restrictions.''

Nonetheless, Carson is thinking about trying out again. ``I can outplay the majority of girls out there, but I don't want my transplant held against me,'' she said. ``I just want a fair tryout. If I make it, I make it. If I don't, I don't.''


On the Net:

U.S. Transplant Games: http://www.kidney.org/recips/athletics/00games/greenframeset.html

World Transplant Games: http://www.transweb.org/webcast/99wtg/index.htm

National Kidney Foundation: http://www.kidney.org

TransWeb, a nonprofit site focusing on transplants: http://www.transweb.org/default.htm