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. 2019 Mar;6(1):45-51.
doi: 10.1007/s40472-019-0231-3. Epub 2019 Feb 9.

Frailty and Long-Term Post-Kidney Transplant Outcomes

Mara A McAdams-DeMarco  1   2 , Nadia M Chu  1   2 , Dorry L Segev  1   2
Affiliations

Frailty and Long-Term Post-Kidney Transplant Outcomes

Mara A McAdams-DeMarco et al. Curr Transplant Rep. 2019 Mar.

Abstract

Purpose of review: To highlight recent research about frailty and its role as a predictor of adverse, long-term post-kidney transplant (KT) outcomes.

Recent findings: Frailty is easily measured using the physical frailty phenotype (PFP) developed by gerontologist Dr. Linda Fried and colleagues. In recent studies, >50% of KT recipients were frail (20%) or intermediately frail (32%) at KT admission. Frail recipients were at 1.3-times higher risk of immunosuppression intolerance and 2.2-times higher risk of mortality, even after accounting for recipient, donor, and transplant factors; these findings were consistent with those on short-term post-KT outcomes. Pilot data suggests that prehabilitation may be an intervention that increases physiologic reserve in frail KT recipients.

Summary: The PFP is a effective tool to measure frailty in ESRD that improves risk stratification for short-term and long-term post-KT outcomes. Interventions to improve physiologic reserve and prevent adverse KT outcomes, particularly among frail KT recipients, are needed.

Keywords: epidemiology; frailty; kidney transplantation.

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Conflict of interest statement

Conflict of Interest Mara McAdams-DeMarco, Nadia Chu, and Dorry Segev declare no conflict of interest.

Figures

FIGURE 1:
FIGURE 1:
Frailty triggers, manifestation, and adverse outcomes among kidney transplant recipients. (Adapted from Walston, 2015 and tailored to KT recipients)
See this image and copyright information in PMC

References

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