Frailty and aging-associated syndromes in lung transplant candidates and recipients

Joanna M. Schaenman, Joshua M. Diamond, John R. Greenland, Cynthia Gries, Cassie C. Kennedy, Amit D. Parulekar, Dmitry Rozenberg, Jonathan P. Singer, Lianne G. Singer, Laurie D. Snyder, Sangeeta Bhorade

Research output: Contribution to journalReview articlepeer-review

Abstract

Many lung transplant candidates and recipients are older and frailer compared to previous eras. Older patients are at increased risk for pre- and posttransplant mortality, but this risk is not explained by numerical age alone. This manuscript represents the product of the American Society of Transplantation (AST) conference on frailty. Experts in the field reviewed the latest published research on assessment of elderly and frail lung transplant candidates. Physical frailty, often defined as slowness, weakness, low physical activity, shrinking, and exhaustion, and frailty evaluation is an important tool for evaluation of age-associated dysfunction. Another approach is assessment by cumulative deficits, and both types of frailty are common in lung transplant candidates. Frailty is associated with death or delisting before transplant, and may be associated with posttransplant mortality. Sarcopenia, cognitive dysfunction, depression, and nutrition are other important components for patient evaluation. Aging-associated inflammation, telomere dysfunction, and adaptive immune system senescence may also contribute to frailty. Developing tools for frailty assessment and interventions holds promise for improving patient outcomes before and after lung transplantation.

Original languageEnglish (US)
Pages (from-to)2018-2024
Number of pages7
JournalAmerican Journal of Transplantation
Volume21
Issue number6
DOIs
StatePublished - Jun 2021

Keywords

  • clinical decision-making
  • clinical research / practice
  • complication: medical / metabolic
  • geriatrics
  • immunobiology
  • lung biology
  • lung transplantation / pulmonology
  • recipient selection
  • risk assessment / risk stratification
  • translational research / science

ASJC Scopus subject areas

  • Immunology and Allergy
  • Transplantation
  • Pharmacology (medical)

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