Report from the American Society of Transplantation on frailty in solid organ transplantation

• Type of Material: Article
• Authors: Jon Kobashigawa, Cedars Sinai Smidt Heart Institute; Darshana Dadhania, Weill Cornell Medicine; Sangeeta Bhorade, Northwestern University; Deborah Adey, University of California San Francisco; Joseph Berger, University of Texas Southwestern Medical Center; Geetha Bhat, Advocate Christ Medical Center; Marie Budev, Cleveland Clinic; Andres Duarte-Rojo, University of Arkansas; Michael Dunn, University of Pittsburgh; Shelley Hall, Baylor University; Meera N. Harhay, Drexel University; Kirsten L. Johansen, University of California San Francisco; Susan Joseph, Baylor University; Cassie C. Kennedy, Mayo Clinic; Evan Kransdorf, Cedars Sinai Smidt Heart Institute; Krista L. Lentine, St Louis University; Raymond Lynch, Emory University; Mara McAdams-DeMarco, Johns Hopkins University; Shunji Nagai, Henry Ford Hospital; Michael Olymbios, Cedars Sinai Smidt Heart Institute; Jignesh Patel, Cedars Sinai Smidt Heart Institute; Sean Pinney, Mt Sinai Hospital; Joanna Schaenman, University of California Los Angeles; Dorry L. Segev, Johns Hopkins University; Palak Shah, Inova Heart & Vascular Institute; Lianne G. Singer, University of Toronto; Jonathan P. Singer, University of California San Francisco; Christopher Sonnenday, University of Michigan; Puneeta Tandon, University of Alberta; Elliot Tapper, University of Michigan; Stefan G. Tullius, Harvard Medical School; Michael Wilson, Mayo Clinic; Martin Zamora, University of Colorado; Jennifer C. Lai, University of California San Francisco
• Language: English
• Date: 2019-04-01
• Publisher: WILEY
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2018 The American Society of Transplantation and the American Society of Transplant Surgeons.
• Final Published Version (URL): http://dx.doi.org/10.1111/ajt.15198
• Title of Journal or Parent Work: American Journal of Transplantation
• Volume: 19
• Issue: 4
• Start Page: 984
• End Page: 994
• Grant/Funding Information: None declared
• Keywords: liver disease; Older habits; Muscle mass; Heart failure; clinical research; practice; Length of Stay; Life Sciences & Biomedicine; pulmonology; Physical activity; Lung transplantation; lung disease; hepatology; kidney disease; Science & Technology; Surgery; Transplantation; immune regulation; heart disease; kidney transplantation; nephrology; Ventricular assist device; liver transplantation; Functional status; Quality improvement; lung transplantation
• Research Categories: Health Sciences, Pathology; Health Sciences, Health Care Management; Health Sciences, Medicine and Surgery

Abstract

A consensus conference on frailty in kidney, liver, heart, and lung transplantation sponsored by the American Society of Transplantation (AST) and endorsed by the American Society of Nephrology (ASN), the American Society of Transplant Surgeons (ASTS), and the Canadian Society of Transplantation (CST) took place on February 11, 2018 in Phoenix, Arizona. Input from the transplant community through scheduled conference calls enabled wide discussion of current concepts in frailty, exploration of best practices for frailty risk assessment of transplant candidates and for management after transplant, and development of ideas for future research. A current understanding of frailty was compiled by each of the solid organ groups and is presented in this paper. Frailty is a common entity in patients with end-stage organ disease who are awaiting organ transplantation, and affects mortality on the waitlist and in the posttransplant period. The optimal methods by which frailty should be measured in each organ group are yet to be determined, but studies are underway. Interventions to reverse frailty vary among organ groups and appear promising. This conference achieved its intent to highlight the importance of frailty in organ transplantation and to plant the seeds for further discussion and research in this field.