Mara A McAdams-DeMarco1,2, Nadia M Chu1,2, Dorry L Segev1,2. 1. Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD. 2. Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
Abstract
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.
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.
Authors: Alvin Thomas; Christine E Haugen; Alexandra Mountford; Fatima Warsame; Rachel Berkowitz; Sunjae Bae; Charles H Brown; Daniel C Brennan; Karin J Neufeld; Michelle C Carlson; Dorry L Segev; Mara McAdams-DeMarco Journal: J Am Soc Nephrol Date: 2018-04-23 Impact factor: 10.121
Authors: Mara A McAdams-DeMarco; Nathan James; Megan L Salter; Jeremy Walston; Dorry L Segev Journal: J Am Geriatr Soc Date: 2014-11-29 Impact factor: 5.562
Authors: M A McAdams-DeMarco; A Law; E King; B Orandi; M Salter; N Gupta; E Chow; N Alachkar; N Desai; R Varadhan; J Walston; D L Segev Journal: Am J Transplant Date: 2014-10-30 Impact factor: 8.086
Authors: Chelsia Gillis; Sarah-Eve Loiselle; Julio F Fiore; Rashami Awasthi; Linda Wykes; A Sender Liberman; Barry Stein; Patrick Charlebois; Francesco Carli Journal: J Acad Nutr Diet Date: 2015-07-21 Impact factor: 4.910
Authors: Qian-Li Xue; Jing Tian; Linda P Fried; Rita R Kalyani; Ravi Varadhan; Jeremy D Walston; Karen Bandeen-Roche Journal: Am J Epidemiol Date: 2016-05-05 Impact factor: 4.897
Authors: Mara A McAdams-DeMarco; Israel O Olorundare; Hao Ying; Fatima Warsame; Christine E Haugen; Rasheeda Hall; Jacqueline M Garonzik-Wang; Niraj M Desai; Jeremy D Walston; Silas P Norman; Dorry L Segev Journal: Transplantation Date: 2018-02 Impact factor: 4.939
Authors: Nadia M Chu; Xiaomeng Chen; Silas P Norman; Jessica Fitzpatrick; Stephen M Sozio; Bernard G Jaar; Alena Frey; Michelle M Estrella; Qian-Li Xue; Rulan S Parekh; Dorry L Segev; Mara A McAdams-DeMarco Journal: Am J Nephrol Date: 2020-07-08 Impact factor: 3.754
Authors: Elizabeth C Lorenz; LaTonya J Hickson; Renee M Weatherly; Karin L Thompson; Heidi A Walker; Judy M Rasmussen; Tara L Stewart; James K Garrett; Hatem Amer; Cassie C Kennedy Journal: Clin Transplant Date: 2020-07-24 Impact factor: 2.863
Authors: Christine E Haugen; Alden Gross; Nadia M Chu; Silas P Norman; Daniel C Brennan; Qian-Li Xue; Jeremy Walston; Dorry L Segev; Mara McAdams-DeMarco Journal: J Gerontol A Biol Sci Med Sci Date: 2021-02-25 Impact factor: 6.053
Authors: JiYoon B Ahn; Sunjae Bae; Nadia M Chu; Lingyu Wang; Jongyeon Kim; Mark Schnitzler; Gregory P Hess; Krista L Lentine; Dorry L Segev; Mara A McAdams-DeMarco Journal: Transplant Direct Date: 2021-06-18
Authors: Nadia M Chu; Xiaomeng Chen; Sunjae Bae; Daniel C Brennan; Dorry L Segev; Mara A McAdams-DeMarco Journal: Transplantation Date: 2021-09-01 Impact factor: 5.385
Authors: Xiaomeng Chen; Omid Shafaat; Yi Liu; Elizabeth A King; Clifford R Weiss; Qian-Li Xue; Jeremy D Walston; Dorry L Segev; Mara A McAdams-DeMarco Journal: Am J Transplant Date: 2022-01-08 Impact factor: 9.369
Authors: María José Pérez-Sáez; Carlos E Arias-Cabrales; Vanesa Dávalos-Yerovi; Dolores Redondo; Anna Faura; María Vera; Anna Bach; Guillermo Pedreira; Ernestina Junyent; Marta Crespo; Ester Marco; Leocadio Rodríguez-Mañas; Julio Pascual Journal: Clin Kidney J Date: 2021-07-10
Authors: María José Pérez-Sáez; Dolores Redondo-Pachón; Carlos E Arias-Cabrales; Anna Faura; Anna Bach; Anna Buxeda; Carla Burballa; Ernestina Junyent; Marta Crespo; Ester Marco; Leocadio Rodríguez-Mañas; Julio Pascual Journal: J Clin Med Date: 2022-01-28 Impact factor: 4.241