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

Bourgeois, Nicholas; Shallwani, Shirin M.; Al-Huda, Fahad S.; Mathur, Sunita; Poirier, Charles; Janaudis-Ferreira, Tânia

doi:10.1097/txd.0000000000001385

Cited by 9 publications

(12 citation statements)

References 124 publications

(230 reference statements)

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“…Reduced exercise capacity and limitations in physical function can be attributed to various factors, including changes in lung mechanics and gas exchange, cardiovascular limitations, peripheral muscle dysfunction, deconditioning, malnutrition fatigue, and anemia [36].…”

Section: Exercise Capacity In Frailtymentioning

confidence: 99%

“…Although lung transplantation can lead to improvements in physical capacity by enhancing organ function and alleviating disease symptoms, transplant recipients still experience impaired exercise capacity, typically achieving only 40-70% of age-predicted values [36][37][38][39]. The International Society for Heart and Lung Transplantation (ISHLT) consensus document for the selection of lung transplant candidates emphasizes that individuals with limited functional status and poor potential for post-transplant rehabilitation are considered absolute contraindications for lung transplantation [19].…”

Section: Exercise Capacity In Frailtymentioning

confidence: 99%

“…This highlights the importance of understanding the relationship between physical function and outcomes both before and after lung transplantation. However, surprisingly, there is a lack of studies investigating the correlation between exercise capacity and outcomes in the context of lung transplantation [36].…”

Section: Exercise Capacity In Frailtymentioning

confidence: 99%

“…Except for the association between the 6-minute walk test (6 MWT) and mortality while awaiting lung transplantation, there is insufficient evidence regarding the relationship between performance-based measures of exercise capacity, frailty, physical function, and clinical outcomes or health care utilization [36].…”

Section: Exercise Capacity In Frailtymentioning

confidence: 99%

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Frailty as a Prognostic Indicator in Lung Transplantation: A Comprehensive Analysis

Hage,

Schuurmans

2023

Transplantology

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Introduction: Frailty is a complex pathobiological process characterized by diminished physiological reserve and increased vulnerability to stressors, which has been associated with unfavorable outcomes before and after lung transplantation. Methods: We undertook an extensive narrative review, encompassing a thorough exploration of original papers, observational studies, case reports, and meta-analyses published between 1990 and July 2023, in various databases, including PubMed, Embase, Cochrane Library, Wiley Online Library databases, and Google Scholar. The search terms [frailty] AND [lung transplant] were utilized. Additionally, the reference lists of retrieved articles were examined. Inclusion criteria comprised studies written in English and involving human subjects. The identified studies were categorized into pre-transplant and post-transplant populations, and the measurement tools used to assess frailty were analyzed, along with the clinical implications reported in the studies. Results: From 1 January 1990 to 1 July 2023, a total of 10 studies on frailty and lung transplantation were identified through online sources and bibliographic searches, involving a total of 2759 patients. Among these studies, six focused on the pre-transplant population, while four examined the post-transplant population. The Fried Frailty Phenotype (FFP) and the Short Physical Performance Battery (SPPB) were the most employed tools for measuring frailty. A table presents additional frailty assessment instruments and the clinical implications described in the studies. Conclusions: Frailty is prevalent both in patients with end-stage respiratory diseases awaiting lung transplantation and in postoperative lung transplant recipients. Most transplant centers recognize the value of assessing frailty in the evaluation of potential candidates for lung transplantation. Frailty has been shown to impact mortality on the waitlist and in the post-transplant period. However, the most effective methods for measuring frailty in lung transplant candidates and recipients have yet to be determined. Strategies to reverse frailty are available and show promising results on outcomes.

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Section: Exercise Capacity In Frailtymentioning

confidence: 99%

Section: Exercise Capacity In Frailtymentioning

confidence: 99%

Section: Exercise Capacity In Frailtymentioning

confidence: 99%

Section: Exercise Capacity In Frailtymentioning

confidence: 99%

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Frailty as a Prognostic Indicator in Lung Transplantation: A Comprehensive Analysis

Hage,

Schuurmans

2023

Transplantology

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“…Solid organ transplantation (SOT) is the preferred treatment option for patients diagnosed with end stage organ failure [ 1 ]. Every year, more than 100,000 SOTs are performed worldwide [ 2 ]. Although in many cases lifesaving, a substantial number of patients experience postoperative adverse events or complications which may impact short- and long-term graft and patient outcomes.…”

Section: Introductionmentioning

confidence: 99%

Prehabilitation in Adult Solid Organ Transplant Candidates

et al. 2023

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Purpose of Review To highlight the importance of biological age in the context of prehabilitation and to present relevant research regarding prehabilitation prior to solid organ transplantation. Recent Findings Studies on the effect of prehabilitation have been performed in kidney-, lung-, liver-, and heart transplant patient populations. Prior to kidney transplantation, exercise interventions have been shown to improve cardiopulmonary- and physical fitness and result in a decreased length of hospital stay postoperatively. Among lung transplant candidates, various methods of prehabilitation have been studied including home-based, outpatient and in-patient programs, consisting of physical training, psychological support, education, and nutritional interventions. Overall, prehabilitation seems to improve or maintain quality of life and exercise capacity in this patient population. Patients undergoing liver transplantation seem to benefit from prehabilitation as well. Not only does it seem safe and feasible, but significant improvements in aerobic and functional capacity have also been found. Regarding heart transplant candidates, both inpatient and outpatient, supervised prehabilitation programs show promising results with improvements in exercise capacities and quality of life. Summary Prehabilitation is an effective and safe intervention for improving functional outcomes of solid organ transplant patients. Future studies should evaluate whether prehabilitation translates into improved pre- and post-transplant clinical outcomes.

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Evaluation of Candidates for Lung Transplant—A Review of Patient-Specific Risk Factors

Leard

2024

Curr Pulmonol Rep

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Purpose of review The purpose of this paper is to review the evaluation of patients who are potential candidates for a lung transplant. Attention is paid to patient-specific risk factors considered when determining if an individual is a candidate for a lung transplant. Recent findings Recent consensus statements and a review of the literature support the notion that patient-specific risk factors associated with adverse outcomes following lung transplant should be identified and used to determine whether an individual patient is a candidate for lung transplant. The rationale for considering these risk factors is discussed. Early referral is encouraged to enable individuals time to reduce risk when modifiable risk factors are identified. Summary Patient-specific risk factors for adverse post-lung transplant outcomes should be identified and modified, if possible, to reduce risk. Additional research is required to better understand which ones place the recipient at the greatest risk and to guide the calculation of acceptable risk. Interprofessional teams at each lung transplant center must consider the combination of patient-specific risk factors in a risk-benefit analysis to make the determination as to whether the candidate will be listed for a lung transplant. These determinations should be transparent, equitable, and communicated clearly.

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

Cited by 9 publications

References 124 publications

Frailty as a Prognostic Indicator in Lung Transplantation: A Comprehensive Analysis

Frailty as a Prognostic Indicator in Lung Transplantation: A Comprehensive Analysis

Prehabilitation in Adult Solid Organ Transplant Candidates

Evaluation of Candidates for Lung Transplant—A Review of Patient-Specific Risk Factors

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