Pretransplant frailty is associated with decreased survival after lung transplantation

Abstract

Pre-transplant frailty was independently associated with decreased survival after lung transplantation. Pre-transplant frailty may represent an important area for intervention to improve candidate selection and lung transplant outcomes.

Frailty phenotypes and mortality after lung transplantation: A prospective cohort study

“…In addition, frailty is associated with delayed graft function, length of stay following transplant surgery, hospital readmission, and mortality after kidney transplantation (15, 17, 30–32). Also, in a single center retrospective study, frailty quantified by the cumulative index model was associated with mortality after lung transplantation (19). This study and our prior work demonstrating that frailty is independently associated with waitlist and post-transplant mortality across age groups adds to this emerging body of work (4).…”

“…This results in a “state-of-risk” for disproportionate declines in health status upon exposure to an additional physiologic stressor (5). Frailty is a risk factor for disability, perioperative complications, and mortality in older medical and surgical populations (6–14) including abdominal organ transplantation (4, 15–19). Further, frailty, defined by an accumulation of deficits, is associated with mortality after lung transplantation (19).…”

The sarcopenia index: A novel measure of muscle mass in lung transplant candidates

“…The secondary aims were to assess ICU, hospital, and 1‐year follow‐up mortality rates, duration of mechanical ventilation, and ICU and hospital LOS. Frailty Deficit Index was defined based on a 32‐item scale that has been previously validated in the lung transplant population . Lung allocation score (LAS) was obtained at the time of lung transplant…”

Consideraciones en la derivación y selección de candidatos a trasplante pulmonar

“…Pocos estudios abordan este tema en trasplante de pulmón y los métodos de su evaluación difieren, pero en general son pacientes que han bajado de peso en forma involuntaria, presentan debilidad muscular y tienen poca actividad física. recientemente se ha visto que la fragilidad es prevalente en candidatos a trasplante pulmonar con un mayor riesgo de ser excluidos de lista y de muerte pre y post trasplante 9,10 . este parámetro podría ser de ayuda en definir mejor los candidatos a trasplante pulmonar, pero son necesarios más estudios para consensuar y validar de mejor manera la fragilidad en el candidato a trasplante, y el impacto de medidas de intervención pre trasplante en los resultados del trasplante.…”