Frailty has a significant influence on postoperative complications after kidney transplantation-a prospective study on short-term outcomes

Schopmeyer, Lasse; Moumni, Mostafa El; Nieuwenhuijs-Moeke, Gertrude J.; Berger, Stefan P.; Bakker, Stephan J. L.; Pol, Robert A.

doi:10.1111/tri.13330

Cited by 34 publications

(34 citation statements)

References 24 publications

(27 reference statements)

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“…Furthermore, the PFP has been found to be feasible to measure in the KT setting (42). Only one study has used a frailty index that summarizes domains of functioning to assess frailty in KT recipients (43); however, this tool, the Groningen Frailty Indicator, is distinct from the PFP. Therefore, we have measured and studied the PFP in over 1,300 KT recipients over the past 10 years.…”

Section: Authors' Personal Views Of Measurement Controversymentioning

confidence: 99%

Frailty and Long-Term Post-Kidney Transplant Outcomes

2019

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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: The PFP is a 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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Section: Authors' Personal Views Of Measurement Controversymentioning

confidence: 99%

Frailty and Long-Term Post-Kidney Transplant Outcomes

2019

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“…Schopmeyer et al [24] associated the occurrence of postoperative complications (30 days after KTx) with the frailty score calculated at admission for KTx using a different tool than that proposed by Fried et al [13]. However, the study also evaluated general postoperative complications as the outcome using the Comprehensive Complication Index (CCI) [40], and not specifically surgical complications.…”

Section: Discussionmentioning

confidence: 99%

“…Studies have shown an association between frailty and general postoperative complications related to KTx [24] and to other types of surgery [25][26][27][28][29], but to the best of our knowledge, no studies have evaluated frailty as a specific predictor of surgical complications after KTx.…”

Section: Introductionmentioning

confidence: 98%

Frailty predicts surgical complications after kidney transplantation. A propensity score matched study

et al. 2020

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Background and objective Surgical complications after kidney transplantation can lead to catastrophic outcomes. Frailty has been associated with important kidney transplantation outcomes; however, there are no studies assessing this measure of physiological reserve as a specific predictor of surgical complications in this population. Such an assessment was, therefore, the objective of the present study. Methods A total of 87 individuals aged � 18 years who underwent kidney transplantation between March 2017 and March 2018 were included. At the time of admission for kidney transplantation, demographic, clinical, and kidney transplantation data were collected, and the frailty score was calculated according to Fried et al., which comprises five components: shrinking, weakness, exhaustion, low activity, and slowed walking speed. Urological, vascular, and general surgical complications were assessed three months later, or until graft loss or death. The propensity score was used to achieve a better homogeneity of the sample, and new analyses were performed in this new, balanced sample. Results Of the 87 individuals included, 30 (34.5%) had surgical complications. After propensity score matching, the risk of surgical complications was significantly higher among the frail individuals (RR 2.14; 95% CI 1.01-4.54; p = 0.035); specifically, the risk of noninfectious

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“…It consists of 15 items, involving physical, cognitive, psychological, and social aspects of frailty. A GFI ≥ 4 has previously been demonstrated to be a reliable cut-off value for considering a patient to be frail [15][16][17][18]. Unlike other frailty instruments, the GFI proved to be both time and cost efficient, given the short time required to complete the test while covering the most important aspects of frailty [19][20][21].…”

Section: Introductionmentioning

confidence: 99%

“…Current research is mainly focused on the effect of frailty on kidney transplantation (KT) outcomes [7,9,16]. Frailty is dynamic, and intervention such as a KT will most likely have an effect on the degree of frailty [22].…”

Section: Introductionmentioning

confidence: 99%

Transitions in frailty state after kidney transplantation

Quint

Schopmeyer

Moers

et al. 2020

Langenbecks Arch Surg

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Purpose Frailty is the body's failure to return to homeostasis after every day or acute stressful events, causing adverse outcomes. To study its dynamics in kidney transplant recipients (KTR), we determined whether the degree of frailty and its domains are affected by kidney transplantation (KT). Methods Between 2015 and 2017, 176 KTR were included. Frailty scores were measured using the Groningen Frailty Indicator (GFI), assessed preoperatively and during follow-up. Transitions in frailty state and changes in the individual domains were determined. Results Mean age (±SD) was 51.8 (± 14.1) years, and 63.1% of KTR were male. Thirty patients were considered frail (GFI ≥ 4) at baseline. After a mean follow-up of 22.8 ± 8.3 months, 34 non-frail patients (19.3%) became frail, 125 patients (71.0%) remained the same, and 17 frail patients (9.7%) became non-frail (GFI < 4). In the domain psychosocial functioning, 28.4% of the patients had an increase in GFI score after follow-up. Patients who scored a point in the domain cognition at baseline had a greater chance of becoming frail (OR 4.38, 95% CI 0.59-32.24). Conclusion In conclusion, almost one-fifth of non-frail KTR transitioned to a frail state after their transplantation. These results could be used to predict the impact of KT on frailty course and help with implementing prehabilitation for patients at risk.

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Frailty has a significant influence on postoperative complications after kidney transplantation-a prospective study on short-term outcomes

Cited by 34 publications

References 24 publications

Frailty and Long-Term Post-Kidney Transplant Outcomes

Frailty and Long-Term Post-Kidney Transplant Outcomes

Frailty predicts surgical complications after kidney transplantation. A propensity score matched study

Transitions in frailty state after kidney transplantation

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