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. 2020 Aug 7:2020:3239495.
doi: 10.1155/2020/3239495. eCollection 2020.

Reversibility of Frailty after Lung Transplantation

Elyn Montgomery  1 , Peter S Macdonald  2 , Phillip J Newton  3 , Sungwon Chang  1 , Kay Wilhelm  2 , Sunita R Jha  1 , Monique Malouf  2
Affiliations

Reversibility of Frailty after Lung Transplantation

Elyn Montgomery et al. J Transplant. .

Abstract

Background: Frailty contributes to increased morbidity and mortality in patients referred for and undergoing lung transplantation (LTX). The study aim was to determine if frailty is reversible after LTX in those classified as frail at LTX evaluation.

Methods: Consecutive LTX recipients were included. All patients underwent modified physical frailty assessment during LTX evaluation. For patients assessed as frail, frailty was reassessed on completion of the post-LTX rehabilitation program. Frailty was defined by the presence of ≥ 3 domains of the modified Fried Frailty Phenotype (mFFP).

Results: We performed 166 lung transplants (frail patients, n = 27, 16%). Eighteen of the 27 frail patients have undergone frailty reassessment. Eight frail patients died, and one interstate recipient did not return for reassessment. In the 18 (66%) patients reassessed, there was an overall reduction in their frailty score post-LTX ((3.4 ± 0.6 to 1.0 ± 0.7), p < 0.001) with 17/18 (94%) no longer classified as frail. Improvements were seen in the following frailty domains: exhaustion, mobility, appetite, and activity. Handgrip strength did not improve posttransplant.

Conclusions: Physical frailty was largely reversible following LTX, underscoring the importance of considering frailty a dynamic, not a fixed, entity. Further work is needed to identify those patients whose frailty is modifiable and establish specific interventions to improve frailty.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
12-month post-LTX survival in frail vs. nonfrail patients.
Figure 2
Figure 2
Outcome of nonfrail vs. frail patients post-LTX following reassessment of frail patients.
Figure 3
Figure 3
Changes to physical frailty score pre-LTX vs. post-LTX.
Figure 4
Figure 4
Changes to physical frailty domains pre-LTX vs. post-LTX.
Figure 5
Figure 5
Changes in DMI-10 score pre-post LTX.
Figure 6
Figure 6
Changes in MOCA score pre-post LTX.
See this image and copyright information in PMC

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