Frailty in Lung Transplantation: Candidate Assessment and Optimization

Agarwal, Ankita; Neujahr, David C.

doi:10.1097/tp.0000000000003671

Cited by 7 publications

(10 citation statements)

References 105 publications

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Section: Introductionmentioning

confidence: 99%

“…Although psychosocial, nutritional and physical impairments impact post-LTx outcomes,1 the clinical operationalisation of frailty measurement in LTx relates overwhelmingly to the physical domain 5 12 13. This may be due to the feasibility of data collection, the younger age of LTx candidates or the complexity associated with cumulative deficit models 12 14. The most commonly reported phenotypic frailty measures collected in clinical practice prior to LTx include the Short Physical Performance Battery (SPPB) and the Fried Frailty Phenotype (FFP) 13 15…”

Section: Introductionmentioning

confidence: 99%

“…Research studies in LTx reflect this phenotype approach. Although conceptualisation and investigation of biomarkers and their links to frailty16 (including in patients with lung disease) have recently been undertaken, the field has lacked established markers or cut-offs, preventing their routine use in the evaluation of frailty for LTx 5 12 13. The recent development of an LTx-specific frailty scale, the Lung Transplant Frailty Scale (LT-FS) and its validation in 342 LTx candidates may help to resolve this 13.…”

Section: Introductionmentioning

confidence: 99%

“…Physical frailty is also associated with an increased risk of readmission after LTx 18. Transplant teams experience the challenges of identifying patients with the physical and psychological reserve necessary to survive such a demanding perioperative and postoperative period and to thrive long term 1 12. This challenge has been exacerbated by the lack of consensus on the optimal assessment tools for frailty in this field,1 which the LT-FS may help to resolve 13.…”

Section: Introductionmentioning

confidence: 99%

“…The aim of LTx is to improve survival, function and quality of life of the recipient, while considering the ethical elements of who will benefit from such a limited pool of donor organs 12. Understanding and targeting reversible components of frailty has the potential to improve physical condition ahead of major surgery, reduce waiting list mortality and potentially impact postoperative outcomes and maximise benefit from LTx 4 12 27. Identifying the best strategies to improve frailty prior to transplantation has been highlighted as an area that requires investigation 4 5 13…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Rehabilitation interventions to modify physical frailty in adults before lung transplantation: a systematic review protocol

McGarrigle,

Norman,

Hurst

et al. 2024

BMJ Open

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IntroductionLung transplantation is the gold-standard treatment for end-stage lung disease for a small group of patients meeting strict acceptance criteria after optimal medical management has failed. Physical frailty is prevalent in lung transplant candidates and has been linked to worse outcomes both on the waiting list and postoperatively. Exercise has been proven to be beneficial in optimising exercise capacity and quality of life in lung transplant candidates, but its impact on physical frailty is unknown. This review aims to assess the effectiveness of exercise interventions in modifying physical frailty for adults awaiting lung transplantation.Methods and analysisThis protocol was prospectively registered on the PROSPERO database. We will search four databases plus trial registries to identify primary studies of adult candidates for lung transplantation undertaking exercise interventions and assessing outcomes pertaining to physical frailty. Studies must include at least 10 participants. Article screening will be performed by two researchers independently at each stage. Extraction will be performed by one reviewer and checked by a second. The risk of bias in studies will be assessed by two independent reviewers using tools appropriate for the research design of each study; where appropriate, we will use Cochrane Risk of Bias 2 or ROBINS-I. At each stage of the review process, discrepancies will be resolved through a consensus or consultation with a third reviewer. Meta-analyses of frailty outcomes will be performed if possible and appropriate as will prespecified subgroup and sensitivity analyses. Where we are unable to perform meta-analysis, we will conduct narrative synthesis following Synthesis without Meta-analysis guidance. The review will be reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist.Ethics and disseminationNo ethical issues are predicted due to the nature of this study. Dissemination will occur via conference abstracts, professional networks, peer-reviewed journals and patient support groups.PROSPERO registration numberCRD42022363730.

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Section: Introductionmentioning

confidence: 99%