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Mensen zoeken woeste plaatsen om op onszelf te reflecteren en onze plaats in de schepping te begrijpen. Bij buitensporten ervaren we de natuurlijke wereld door fysieke inspanning als een uitdrukking van Gods majesteit. Dit essay bespreekt het ‘buiten’ theologisch als een geestelijke discipline gericht op het bewonderen van het ‘prachtige boek’ van de natuur, gebaseerd op de ervaringen van studenten tijdens een vak, een theologische verkenning van Psalm 8, een esthetisch-doxologische interpretatie van de boekmetafoor, en het concept van resonantie bij Hartmut Rosa.
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.