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For the treatment of terminal heart failure, heart transplantation is consideredto be the gold standard, leading to significantly improved quality of life andlong-time survival. For heart transplant recipients, the development andmaintenance of good functional performance and adequate exercise capacity iscrucial for renewed participation and integration in self-determined live. Inthis respect, typical transplant-related alterations must be noted that play asignificant role, leading to restrictions both centrally and peripherally.Before patients begin intensive and structured exercise training, acomprehensive diagnosis of their exercise capacity should take place in order tostratify the risks involved and to plan the training units accordingly.Particularly endurance sports and resistance exercises are recommended tocounter the effects of the underlying disease and the immunosuppressivemedication. The performance level achieved can vary considerably depending ontheir individual condition, from gentle activity through a non-competitive-levelto intensive competitive sports. This paper includes an overview of the currentliterature on heart transplant recipients, their specific characteristics, aswell as typical cardiovascular and musculoskeletal alterations. It alsodiscusses suitable tools for measuring exercise capacity, recommendations forexercise training, required precautions and the performance level usuallyachieved.

Exercise after Heart Transplantation: Typical Alterations, Diagnostics and Interventions