Incentive Spirometer in Liver Transplant Recipients

In this prospective , randomized study, 40 adults undergoing living-donor liver transplantation (LT) were assigned to standard post-transplant mobilization and breathing exercises alone (n=20) or standard exercises plus structured IS training (n=20). Arterial blood gases ABG parameters (pH, PO₂, PCO₂, HCO₃-, SpO₂) were measured at baseline and on postoperative days 1-3. Linear mixed-effects models assessed group differences in ABG trajectories; slope analyses quantified decline and recovery phases. Secondary outcomes included intensive care unit (ICU) and hospital length of stay (LOS) and Post-operative pulmonary complications incidence.

Inclusion criteria

• age between 18 and 65 years,
• scheduled to undergo Living Donor Liver Transplant (LDLT) as recipients
• able to understand and follow instructions for incentive spirometry use

Exclusion criteria

• multiorgan transplantation
• moderate-to-severe pleural effusion at baseline
• persistent elevation in renal function tests
• history of bleeding esophageal varices within the preceding month
• multicentric hepatocellular carcinoma (HCC)
• active smoking
• decompensated cardiac disease
• alcoholic hepatitis as the primary etiology
• cognitive impairment or blindness precluding participation in the rehabilitation protocol.