Frailty assessment and candidate optimization before cardiothoracic transplantation

TL;DR

This paper reviews how frailty affects outcomes in cardiothoracic transplant patients and emphasizes the importance of addressing frailty before surgery.

Contribution

The paper provides a comprehensive review on defining, measuring, and treating frailty in heart and lung transplant candidates.

Findings

Frailty is linked to poor perioperative outcomes in cardiothoracic transplant patients.

Early identification and treatment of frailty can reduce comorbidity and mortality.

Physiologic reserve is a core issue in frailty that impacts transplant outcomes.

Abstract

Frailty is an important syndrome in an aging thoracic transplant population, particularly in the context of end-stage cardiopulmonary disease. In this review, we discuss the core problem of lack of physiologic reserve in these patients and its relationship to perioperative outcomes, how to define and measure frailty in the context of heart and lung transplant and identify interventions to treat contributors to this clinical syndrome. We highlight the critical need in the transplant community to identify and treat these conditions prior to their transplantation and to prevent comorbidity and mortality.

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