Frailty and Long-Term Post-Kidney Transplant Outcomes

摘要

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. 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.