Efficacy of Multimodal Prehabilitation of Liver Donors in enhancing Post Operative Recovery - A Randomized Controlled Study

All individuals being worked up under the Department of Gastrointestinal Surgery and Multi-Visceral Organ Transplantation for Donor Hepatectomy will be recruited in the study after obtaining written informed consent.

Demographic details (Patient’s Name, Age, Phone number and Gender), and Anthropometric parameter (Height, Weight, BMI, Waist circumference) are recorded.

Patient comorbidities (diabetes, hypertension, dyslipidaemia and hypothyroidism) are documented.

Donors are randomly assigned to 2 groups using computer generated randomization to a study and a control arm by the randomization protocol explained above. Patients in the study arm are subjected to a minimum of 2 weeks of prehabilitation which include: - Tailored Monitored High Intensity Interval Training (HIIT) exercise, A high protein, low fat diet with total calorie intake equalling the basal requirement and education and encouragement to practice Inspiratory muscle training (IMT) and Incentive Spirometry (IS).

Baseline laboratory investigations include, CBC, LFT, RFT, Lipid profile, PT - INR, S.E and Liver regeneration markers.

Intra operatively, Wedge liver biopsy is taken in all the Graft livers during bench preparation. Following the Donor Hepatectomy, the donors are observed in the ICU for 3/4 days and later shifted to the ward. Routine labs including LFT and PT-INR are done daily, and they are usually discharged by day 6/7 in case of an uneventful post-op period.

Follow up is done after 14-21 days with routine labs and Plain CT to check for liver regeneration volumetry.