Frailty and the Kidney Transplant Wait List

Many people with advanced kidney disease will benefit from a kidney transplant. Some people are not eligible because they are have health conditions that put them at a high risk of dying before receiving a transplant or high risk of deteriorating health after a transplant. Deciding who is able to receive a transplant involves a detailed evaluation of a person's health and a review by transplant specialists. Some people with kidney disease who are being considered for a kidney transplant have difficulties in their health, mobility or function that put them at a risk for a shortened lifespan. This is often referred to as frailty. Currently, we do not know how being frail might affect the health of those who are waiting for a kidney transplant. Knowing this information could be helpful in a number of ways. It would provide transplant specialists with information to allow them to make an informed, objective decision about whether patients should be put on the wait list and not rely solely on their clinical impression. It would also provide a more complete picture of a person's overall health in addition to the tests that are currently used to better inform patients who are deciding about being put on the wait list. In this study, we aim to examine what happens to people who are frail and wait listed for a kidney transplant compared with those who are not frail. We will use several different tools to assess frailty. We will follow patients to see if they die or are removed from the wait list before they can receive a transplant in addition to a number of other important outcomes such as being admitted to hospital or changes in their quality of life. We hope that the results of this study may lead to better allocation of kidney transplant organs and a more objective method of evaluating eligibility for the wait list.