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Integrating Frailty into the Kidney Transplant Evaluation

  • Frailty and Gerontology (M McAdams-Demarco, Section Editor)
  • Published:
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Abstract

Purpose of Review

This review presents an overview of the clinical syndrome of frailty and its association with kidney transplantation outcomes, recent developments in refining frailty assessment, and considerations for its implementation into kidney transplant evaluation.

Recent Findings

Recent studies show that frailty is associated with adverse clinical outcomes before and after kidney transplantation, including decreased likelihood of listing and increased risks of mortality. However, frailty assessment has yet to be fully adopted by transplant centers; a study found that 40.9% of centers reported never assessing frailty at evaluation of kidney transplant candidates. Geriatric transplant experts and kidney transplant candidates agree that frailty is a valid consideration for evaluating candidacy.

Summary

While frailty is an important consideration for treatment of patients with end-stage renal disease, its use in kidney transplant evaluation remains under-utilized. Future research is necessary to refine the frailty phenotype for effective integration into a kidney transplant context.

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References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

    Recently published papers of particular interest have been denoted as:• Of importance •• Of major importance

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    Funding

    This work was supported by grant number R01AG055781 (McAdams-DeMarco) and R01AG077888 (McAdams-DeMarco) from the National Institute of Aging (NIA). Dr. Segev was supported by K24AI144954 from the National Institute of Allergy and Infectious Diseases.

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    1. Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA

      Valerie L. Thompson & Dorry L. Segev

    2. Department of Surgery, New York University Grossman School of Medicine and Langone Health, New York, NY, USA

      Mara McAdams-DeMarco

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    1. Valerie L. Thompson
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    Correspondence to Mara McAdams-DeMarco.

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    Thompson, V.L., Segev, D.L. & McAdams-DeMarco, M. Integrating Frailty into the Kidney Transplant Evaluation. Curr Transpl Rep 10, 12–20 (2023). https://doi.org/10.1007/s40472-023-00389-2

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