To evaluate the feasibility and impact of a home based preoperative exercise and Nutrition intervention in patients with high liver frailty index on post liver transplant outcomes - a prospective interventional Trial

Liver fraility index (LFI) assessment will be performed by the physiotherapist routinely for all liver transplant recipients as part of pre transplant evaluation. Patients with LFI above 4.0 will be enrolled in the study at the point of first contact. Dietary and exercise plan will be formulated as per the patient needs and capacity respectively. The patients will be educated regarding the need for the nutritional and exercise interventions. Fornightly compliance check will be performed telephonically or in person. Repeat assessment of LFI will be done a day prior to transplant. Post transplantation, limb and chest physiotherapy will commence from postoperative day 1 and dietician review will be taken once feeding can be started. During the time of discharge further dietary plans and exercise regimen will be provided to the patients. At the end of 3 months further review of nutritional status, functional capacity, LFI and quality of life will be done. Quality of life will be assessed repeated at the end of one year post transplantation.