Abstract

Given the potential utility of frailty, a clinical phenotype of decreased physiologic reserve and resistance to stressors, to predict post-kidney transplant (KT) outcomes, we sought to understand the perceptions and practices regarding frailty measurement in US KT programs.Surveys were emailed to American Society of Transplantation Kidney/Pancreas Community of Practice members and 202 US transplant programs (11/2017-4/2018). Program characteristics were gleaned from SRTR.The 133 responding programs (response rate=66%) represented 77% of adult KTs and 79% of adult KT candidates in the US. Respondents considered frailty to be a useful concept in evaluating candidacy (99%) and endorsed a need to develop a frailty measurement specific to KT (92%). Frailty measurement was more common during candidacy evaluation (69%) than during KT admission (28%). Of the 202 programs, 38% performed frailty assessments in all candidates while 23% performed assessments only for older candidates. There was heterogeneity in the frailty assessment method; 18 different tools were utilized to measure frailty. The most common tool was a timed walk test (19%); 67% reported performing >1 tool. Among programs that measure frailty, 53% reported being less likely to list frail patients for KT.Among US KT programs, frailty is recognized as a clinically relevant construct and is commonly measured at evaluation. However, there is considerably heterogeneity in the tools used to measure frailty. Efforts to identify optimal measurement of frailty using either an existing or novel tool and subsequent standardization of its measurement and application across KT programs should be considered.

View details for DOI 10.1097/TP.0000000000002779

View details for PubMedID 31343576