Even protein distribution plus exercise for people awaiting liver transplant

Evaluation of Protein Distribution Optimization With Exercise Regimen on Nutritional Status, Body Composition and Functional Status in Patients Awaiting Liver Transplantation: The POWER-LT Randomized Clinical Trial

Not applicable Interventional Agricultural University of Athens · NCT07561138

This trial tests whether spreading daily protein evenly and combining it with a 12-week exercise program improves nutrition, muscle mass, and function in people waiting for a liver transplant compared with uneven protein timing or usual advice.

Quick facts

PhaseNot applicable
Study typeInterventional
Enrollment90 (estimated)
Ages18 Years to 70 Years
SexAll
SponsorAgricultural University of Athens Academic / other
Locations2 sites (Athens, Attica and 1 other locations)
Trial IDNCT07561138 on ClinicalTrials.gov

What this trial studies

This randomized controlled trial enrolls liver transplant candidates and assigns them to one of three 12-week approaches: an even protein distribution diet plus supervised exercise, a skewed protein distribution diet plus the same exercise program, or standard dietary and physical activity advice. Primary outcomes include nutritional status, body composition, and functional status, while secondary outcomes cover anthropometry, laboratory parameters, quality of life, disease severity, complications, and mortality. For participants who undergo transplantation, the study will also record postoperative outcomes such as ICU and hospital length of stay, ventilation duration, complications, readmissions, reoperations, and mortality. Interventions are delivered at clinical sites in Athens with regular follow-up visits and objective measures of muscle and function.

Who should consider this trial

Good fit: Adults with end-stage liver disease or cirrhosis who are referred for or listed for liver transplantation, have an expected wait of at least three months, have not received prior formal dietary advice, can safely exercise, and can provide informed consent are ideal candidates.

Not a fit: Patients with exercise contraindications (for example recent variceal bleeding, severe encephalopathy, refractory ascites), chronic kidney disease requiring protein restriction, very short expected wait or life expectancy under three months, pregnancy, or inability to adhere to the program are unlikely to benefit.

Why it matters

Potential benefit: If successful, this approach could strengthen nutrition and muscle mass before transplant and potentially reduce postoperative complications and shorten recovery.

How similar studies have performed: Even protein distribution has been shown to boost muscle protein synthesis in healthy adults and exercise prehabilitation has benefited other surgical populations, but randomized data specifically in end-stage liver disease are limited.

Eligibility criteria

Show full inclusion / exclusion criteria
Inclusion Criteria:

* End-stage liver disease, diagnosed by transient elastography (FibroScan) or imaging-based evaluation with compatible clinical picture
* Referred for liver transplantation and evaluated to have a high likelihood of being listed, according to primary hepatologist assessment, or already listed for liver transplantation
* No prior formal dietary advice

Exclusion Criteria:

* Age \< 18 years old
* Estimated waiting time for liver transplantation \< 3 months
* Estimated life expectancy \< 3 months
* Chronic kidney disease requiring protein restriction
* Exercise contraindicated (e.g., active or recent variceal bleeding, severe grade of hepatic encephalopathy, refractory ascites, etc.)
* Unstable or severe psychiatric disorder
* Pregnancy or lactation
* Inability to provide written informed consent

Where this trial is running

Athens, Attica and 1 other locations

Study contacts

How to participate

  1. Review the eligibility criteria above with your treating physician.
  2. Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
  3. Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.
Conditions End-stage Liver DiseaseLiver CirrhosisLiver TransplantationMalnutritionSarcopeniaFrailtyliver diseaseend-stage liver disease
Last reviewed 2026-06-13 by the Find a Trial editorial team. Information on this page is for educational purposes and is not medical advice. Always consult qualified healthcare professionals about clinical trial participation.