Fig. 4: Exercise prescription augmentation strategy in end-stage liver disease.

Following a baseline assessment with liver transplant physical therapists, all potential candidates get a home-based tailored exercise prescription. Local gyms or other training resources are explored and incentivized for patients who have the autonomy to attend those places. At each follow-up visit, providers reassess and adjust prescription, augmenting to a home-based supervised program, and for those who fail to get stronger with this intervention, to a site-based supervised program (we usually start with an outpatient facility). Some of these patients need to attend a dedicated clinic able to handle frequent and personalized follow-up appointments. Importantly, patients with ESLD-related cardiopulmonary complications should be referred to their corresponding specialist (e.g., pulmonary hypertension rehabilitation or heart failure rehabilitation).