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

Jon Kobashigawa, Darshana Dadhania, Sangeeta Bhorade, Deborah Adey, Joseph Berger, Geetha Bhat, Marie Budev, Andres Duarte-Rojo, Michael Dunn, Shelley Hall, Meera N Harhay, Kirsten L Johansen, Susan Joseph, Cassie C Kennedy, Evan Kransdorf, Krista L Lentine, Raymond J Lynch, Mara McAdams-DeMarco, Shunji Nagai, Michael Olymbios, Jignesh Patel, Sean Pinney, Joanna Schaenman, Dorry L Segev, Palak Shah, Lianne G Singer, Jonathan P Singer, Christopher Sonnenday, Puneeta Tandon, Elliot Tapper, Stefan G Tullius, Michael Wilson, Martin Zamora, Jennifer C Lai, Jon Kobashigawa, Darshana Dadhania, Sangeeta Bhorade, Deborah Adey, Joseph Berger, Geetha Bhat, Marie Budev, Andres Duarte-Rojo, Michael Dunn, Shelley Hall, Meera N Harhay, Kirsten L Johansen, Susan Joseph, Cassie C Kennedy, Evan Kransdorf, Krista L Lentine, Raymond J Lynch, Mara McAdams-DeMarco, Shunji Nagai, Michael Olymbios, Jignesh Patel, Sean Pinney, Joanna Schaenman, Dorry L Segev, Palak Shah, Lianne G Singer, Jonathan P Singer, Christopher Sonnenday, Puneeta Tandon, Elliot Tapper, Stefan G Tullius, Michael Wilson, Martin Zamora, Jennifer C Lai

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.

Keywords: clinical research/practice; heart disease; immune regulation; kidney disease; kidney transplantation/nephrology; liver disease; liver transplantation/hepatology; lung disease; lung transplantation/pulmonology.

Conflict of interest statement

Disclosure

The authors of this manuscript have conflicts of interest to disclose as described by the American Journal of Transplantation. Cassie Kennedy, MD has received a research grant from the National Institutes of Health (Grant Number: HL 128859). The other authors have no conflicts of interest to disclose.

© 2018 The American Society of Transplantation and the American Society of Transplant Surgeons.

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