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Review
. 2024 Aug 2;13(15):4537.
doi: 10.3390/jcm13154537.

Frailty after Liver Transplantation: A Complex Unexplored Issue

Filippo Gabrielli  1   2 , Filippo Biagi  3 , Alessandra Avossa  3 , Margherita Falcini  3 , Fabio Nascimbeni  1 , Pietro Andreone  1   4 , Stefano Gitto  3
Affiliations
Review

Frailty after Liver Transplantation: A Complex Unexplored Issue

Filippo Gabrielli et al. J Clin Med. .

Abstract

Frailty is a multidimensional syndrome predominantly studied in the elderly, characterized by reduced resistance to stressors due to diminished physiological reserve and resilience. Advances in surgical techniques and immunosuppressive drugs have improved long-term survival rates in solid organ transplant recipients, yet the 10-year survival is satisfying. However, liver transplant recipients have a noteworthy risk of developing frailty status. After liver transplant, frailty can be favored by socioeconomic, cultural, and health-related factors, leading to increased risks of hospitalization, morbidity, and mortality. Various tools for frailty assessment exist, but none are universally validated for post-transplant patients. The integration of socioeconomic and psychological factors into frailty evaluation could improve quality of life and long-term outcomes for transplant recipients. Multidisciplinary approaches, including psychosocial support, are essential for managing frailty and enhancing the overall care of transplanted patients. This narrative review aims to comprehensively address the principal frailty risk factors associated with liver transplantation.

Keywords: frailty; frailty assessment tools; liver transplantation; sarcopenia.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
The main factors that can potentially favor the development of frailty status in liver transplant recipients. Psychiatric disorders and social problems, both pre-existing and de novo post-transplant, such as depression, loneliness, and relapse into alcohol use, as well as immunosuppressive therapy—which may increase the risk of de novo malignancies—and a sedentary lifestyle that contributes to cardiovascular risk, are factors that can contribute to frailty in post-OLT patients.
See this image and copyright information in PMC

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