BACKGROUND: It is generally unknown to what extent organ transplant recipients can be physically challenged. During an expedition to Mount Kilimanjaro, the tolerance for strenuous physical activity and high-altitude of organ transplant recipients after various types of transplantation was compared to non-transplanted controls.METHODS: Twelve organ transplant recipients were selected to participate (2 heart-, 2 lung-, 2 kidney-, 4 liver-, 1 allogeneic stem cell- and 1 small bowel-transplantation). Controls comprised the members of the medical team and accompanying family members (n = 14). During the climb, cardiopulmonary parameters and symptoms of acute mountain sickness were recorded twice daily. Capillary blood analyses were performed three times during the climb and once following return.RESULTS: Eleven of the transplant participants and all controls began the final ascent from 4700 meters and reached over 5000 meters. Eight transplant participants (73%) and thirteen controls (93%) reached the summit (5895m). Cardiopulmonary parameters and altitude sickness scores demonstrated no differences between transplant participants and controls. Signs of hyperventilation were more pronounced in transplant participants and adaptation to high-altitude was less effective, which was related to a decreased renal function. This resulted in reduced metabolic compensation.CONCLUSION: Overall, tolerance to strenuous physical activity and feasibility of a high-altitude expedition in carefully selected organ transplant recipients is comparable to non-transplanted controls.
BACKGROUND: It is generally unknown to what extent organ transplant recipients can be physically challenged. During an expedition to Mount Kilimanjaro, the tolerance for strenuous physical activity and high-altitude of organ transplant recipients after various types of transplantation was compared to non-transplanted controls.METHODS: Twelve organ transplant recipients were selected to participate (2 heart-, 2 lung-, 2 kidney-, 4 liver-, 1 allogeneic stem cell- and 1 small bowel-transplantation). Controls comprised the members of the medical team and accompanying family members (n = 14). During the climb, cardiopulmonary parameters and symptoms of acute mountain sickness were recorded twice daily. Capillary blood analyses were performed three times during the climb and once following return.RESULTS: Eleven of the transplant participants and all controls began the final ascent from 4700 meters and reached over 5000 meters. Eight transplant participants (73%) and thirteen controls (93%) reached the summit (5895m). Cardiopulmonary parameters and altitude sickness scores demonstrated no differences between transplant participants and controls. Signs of hyperventilation were more pronounced in transplant participants and adaptation to high-altitude was less effective, which was related to a decreased renal function. This resulted in reduced metabolic compensation.CONCLUSION: Overall, tolerance to strenuous physical activity and feasibility of a high-altitude expedition in carefully selected organ transplant recipients is comparable to non-transplanted controls.
Gelijkwaardige kansen om te ontwikkelen in de samenleving Nederland ondertekende in maart 2007 het VN Verdrag voor de Rechten van mensen met beperking. Het verdrag beoogt dat de circa 650 miljoen mensen met een handicap wereldwijd op dezelfde wijze als anderen kunnen deelnemen aan het maatschappelijke leven en de universele rechten van de mens kunnen genieten. Het verdrag verplicht de lidstaten om sociale en fysieke belemmeringen weg te nemen die gehandicapten dagelijks ervaren. Nederland onderschrijft de VN Standaardregels voor Gelijke Kansen voor Mensen met beperking waarin staten worden opgeroepen gelijke kansen te bieden door alle aspecten van het maatschappelijke verkeer voor iedereen toegankelijk te maken. Ook onderschreef Nederland in 1994 de Verklaring van Salamanca van Unesco waarin staat dat ieder kind een fundamenteel recht heeft op onderwijs en in staat moet worden gesteld een acceptabel niveau van leren te bereiken en op peil te houden. Allen met speciale onderwijsbehoeften moeten toegang hebben tot reguliere scholen, welke hen opnemen in een kindgericht pedagogisch klimaat dat in staat is aan hun behoeften tegemoet te komen. In het inclusiemanifest wordt beschreven dat het Nederlandse Wetboek van Strafrecht stelt dat elke vorm van onderscheid, uitsluiting, beperking of voorkeur, die ten doel heeft of ten gevolge kan hebben dat de erkenning, het genot of de uitoefening op voet van gelijkheid van de rechten van de mens en de fundamentele vrijheden op politiek, economisch, sociaal, cultureel of andere terreinen van het maatschappelijke leven, wordt teniet gedaan of aangetast strafbaar is.
