Abstract
Purpose of Review
To highlight recent research about frailty and its role as a predictor of adverse, long-term post-kidney transplant (KT) outcomes.
Recent Findings
Frailty is easily measured using the physical frailty phenotype (PFP) developed by gerontologist Dr. Linda Fried and colleagues. In recent studies, > 50% of KT recipients were frail (20%) or intermediately frail (32%) at KT admission. Frail recipients were at 1.3-times higher risk of immunosuppression intolerance and 2.2-times higher risk of mortality, even after accounting for recipient, donor, and transplant factors; these findings were consistent with those on short-term post-KT outcomes. Pilot data suggests that prehabilitation may be an intervention that increases physiologic reserve in frail KT recipients.
Summary
PFP is an effective tool to measure frailty in ESRD that improves risk stratification for short-term and long-term post-KT outcomes. Interventions to improve physiologic reserve and prevent adverse KT outcomes, particularly among frail KT recipients, are needed.
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Funding
This study was supported by the National Institute of Diabetes and Digestive and Kidney Disease (NIDDK) grant numbers: R01DK114074 (PI: McAdams-DeMarco), K24DK101828 (PI: Segev), and the National Institute on Aging (NIA) grant numbers: R01AG042504 (PI: Segev), K01AG043501 (PI: McAdams-DeMarco), and R01AG055781 (PI: McAdams-DeMarco). Mara A. McAdams-DeMarco was also supported by the Johns Hopkins University Claude D. Pepper Older Americans Independence Center (P30AG021334).
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Mara McAdams-DeMarco, Nadia Chu, and Dorry Segev declare no conflict of interest.
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McAdams-DeMarco, M.A., Chu, N.M. & Segev, D.L. Frailty and Long-Term Post-Kidney Transplant Outcomes. Curr Transpl Rep 6, 45–51 (2019). https://doi.org/10.1007/s40472-019-0231-3
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DOI: https://doi.org/10.1007/s40472-019-0231-3