A Contraindication for Transplantation? Consequences of Frailty on Immunity and Immunosuppression

摘要

Purpose of Review Frailty has gained clinical relevance. While the condition may negatively impact outcomes, organ transplantation may also improve frailty. Notably, available assessment tools are broad and have not allowed for a detailed analysis or prognosis. Recent Findings Frailty has been linked to adverse surgical outcomes while imparting on immune competency. Immunosuppressive treatment may therefore require modifications in frail patients, and effects on drug metabolism may need consideration. Moreover, cognitive impairment may impact compliance. Here, we provide a comprehensive update on clinical features, diagnostics, consequences on immunity and immunosuppression, and clinical outcomes. Clinical studies have shown promising outcomes for some frail transplant recipients. Relevant open questions include patient selection, adaptation of immunosuppression, potential to improve frailty, compliance, and transplant outcomes.