An update on frailty in lung transplantation

Varughese, Rhea; Rozenberg, Dmitry; Singer, L.G.

doi:10.1097/mot.0000000000000762

Cited by 14 publications

(29 citation statements)

References 32 publications

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“…Among the SOT recipients in this study, pre-frailty by the mFFI was present in 15 (44%) participants at 12 months post-transplant. This is similar in prevalence to the in-person assessment of physical frailty after lung, kidney, liver, or heart transplantation (Harhay et al, 2929; Jha et al, 2017 ; Lai et al, 2018 ; MacDonald, 2021 ; Varughese et al, 2020 ). The simple question about opening a jar may be an alternative to handgrip strength for evaluating muscle weakness remotely.…”

Section: Discussionsupporting

confidence: 66%

“…Frailty is an increased state of vulnerability due to a decline in function across multiple physiologic systems ( Exterkate et al, 2016 ; Watford et al, 2021 ). Among solid organ transplant (SOT) patients, frailty is an important clinical marker associated with increased risk of waitlist death/delisting, post-transplant mortality in kidney, heart, and lung transplant recipients ( Montgomery et al, 2020 ; Varughese at al., 2020 , 2021 ), and increased risk of graft dysfunction and delirium in kidney transplant recipients ( Harhay et al, 2020 ). The most common measure of physical frailty is the Fried Frailty Index (FFI) ( Fried et al, 2001 ), which includes five domains: muscle weakness, low physical activity, weight loss, slowness, and exhaustion ( Kobashigawa et al, 2019 ).…”

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confidence: 99%

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Feasibility of Virtual Assessment of Physical Frailty in Solid Organ Transplant Recipients – A Single Centre, Observational Study

et al. 2022

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Objectives: To describe the feasibility of virtual assessments of physical frailty in solid organ transplant (SOT) recipients using a modified Fried Frailty Index (mFFI) and Short Physical Performance Battery (SPPB), and to describe the prevalence of frailty 12-months post-transplant using virtual assessment. Methods: Virtual assessments were performed using an e-questionnaire and a video-call for functional tests. Feasibility variables included: internet quality, video-call duration, presence of a companion, and adverse events. Results: 34 SOT recipients, median age 62 (46-67), 76% lung recipients, 47% female, were included. The video-call had a median duration of 12 minutes (10-15 min), without adverse events. A companion was present in 23 (68%) video-call assessments. Fifteen SOT recipients (44%) were classified as pre-frail by the mFFI, and none were frail. Three participants (8.8%) were classified as frail using the SPPB. Conclusion: Virtual frailty assessments can be used as an alternative to in-person assessments in SOT recipients.

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Section: Discussionsupporting

confidence: 66%

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confidence: 99%

Feasibility of Virtual Assessment of Physical Frailty in Solid Organ Transplant Recipients – A Single Centre, Observational Study

et al. 2022

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“…The authors concluded that frailty was associated with a poorer health-related QOL, pretransplant delisting, and pre-and posttransplant mortality. 115 Aligned with these findings, our review identified some relationship of the SPPB with survival posttransplant and QOL but only in a limited number of studies. In other solid organ transplant groups, frailty, measured by the SPPB and Fried Frailty Index, has been shown to be related to waitlist mortality in liver 116 and lung 117 transplant candidates and to post-kidney transplant mortality.…”

Section: Discussionmentioning

confidence: 88%

“…Another explanation could be that‚ although the importance of frailty in transplantation has grown recently, the assessment of frailty is not being performed routinely pre- or posttransplant in the clinics or research studies. One recent narrative review 115 presented information on the relationship of the SPPB, Fried Frailty Phenotype, and Cumulative Deficits Frailty Index with pre- and posttransplant outcomes in lung transplantation. The authors concluded that frailty was associated with a poorer health-related QOL, pretransplant delisting, and pre- and posttransplant mortality.…”

Section: Discussionmentioning

confidence: 99%

Relationship of Exercise Capacity, Physical Function, and Frailty Measures With Clinical Outcomes and Healthcare Utilization in Lung Transplantation: A Scoping Review

Bourgeois

Shallwani

Al-Huda

et al. 2022

Transplantation Direct

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Background. Measures of exercise capacity, frailty, and physical function are commonly used in lung transplant candidates and recipients to evaluate their physical limitations and the effects of exercise training and to select candidates for transplantation. It is unclear how these measures are related to clinical outcomes and healthcare utilization before and after lung transplantation. The purpose of this scoping review was to describe how measures of exercise capacity, physical function, and frailty are related to pre- and posttransplant outcomes. Methods. We considered studies of any design that included performance-based tests of exercise capacity, physical function, and frailty in adult lung transplant candidates or recipients. Outcomes of interest were clinical outcomes (eg, mortality, quality of life) and healthcare utilization. Results. Seventy-two articles met the inclusion criteria. The 6-min walk test (6MWT) was shown to be related to mortality on the waiting list with different distance values as cutoffs points. There were inconsistent results regarding the relationship of the 6MWT with other clinical outcomes. Few studies have examined the relationship between the cardiopulmonary exercise test or the short physical performance battery and clinical outcomes, although some studies have shown relationship with survival posttransplant and quality of life. Few studies examined the relationship between the tests of interest and healthcare utilization‚ and the results were inconsistent. Conclusions. Except for the relationship between the 6MWT and mortality on the waiting list, there is limited evidence regarding the relationship of performance-based measures of exercise capacity, frailty, and physical function with clinical outcomes or healthcare utilization.

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“…Frailty remains a prevalent diagnosis among lung transplant candidates and may be a modifiable factor for survival. 37…”

Section: Lung Transplantationmentioning

confidence: 99%

Year in Review 2020: Noteworthy Literature in Cardiothoracic Critical Care

Gilliland

Tran

Alber

et al. 2021

Semin Cardiothorac Vasc Anesth

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This year will be forever marked by the drastic changes COVID-19 wrought on our personal and professional lives. New roles and challenges in critical care have forced us to be constantly nimble and flexible in how we approach medicine. The strain of these challenges is apparent throughout the health care community and our society as a whole. Despite this adversity, 2020 will also be remembered for fantastic advances in research. This article is a collection of influential and exciting studies published in 2020 encompassing a broad swath of critical care with a focus on cardiothoracic critical care. Themes include examinations of early extracorporeal membrane oxygenation support for out-of-hospital cardiac arrest patients, the impact of sedation and other risk factors on perioperative mortality, a novel fluid resuscitation strategy following cardiac surgery, and advances in the fields of heart and lung transplantation as well as how they were affected by COVID-19. Given that many cardiothoracic intensivists were redeployed to the care of SARS-CoV-2 patients, we also discuss important advances in therapeutics for the virus.

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An update on frailty in lung transplantation

Cited by 14 publications

References 32 publications

Feasibility of Virtual Assessment of Physical Frailty in Solid Organ Transplant Recipients – A Single Centre, Observational Study

Feasibility of Virtual Assessment of Physical Frailty in Solid Organ Transplant Recipients – A Single Centre, Observational Study

Relationship of Exercise Capacity, Physical Function, and Frailty Measures With Clinical Outcomes and Healthcare Utilization in Lung Transplantation: A Scoping Review

Year in Review 2020: Noteworthy Literature in Cardiothoracic Critical Care

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