New approaches to evaluating frailty in solid organ transplantation

Solid organ transplantation is a life-saving treatment for people with organ failure, but organ donors and recipients must be chosen carefully since transplants are risky and donor organs are so scarce. In recent years, transplant programs have been accepting older donors and recipients with more chronic health problems. It is possible that some of these patients are frail - in other words, their bodies are less able to withstand stress - and this may lead to poor outcomes after transplantation. We do not know how best to measure frailty in organ transplant candidates and recipients. Without appropriate tools to measure frailty, we do not know if frail patients get as much benefit from transplantation as non-frail individuals, or how to help frail patients with organ failure have longer and better lives before and after transplantation though exercise or other treatments. We also do not know whether organs from frail people can safely be used for transplantation. The objective of this study is to develop and test the usefulness of a new tool to measure frailty in donors and candidates for heart, lung, kidney or liver transplantation. We will determine whether frailty is associated with worse health outcomes before and after transplantation. The results of this study will help transplant programs better predict benefit from organ transplantation, will improve our understanding of the aging process and how it is affected by transplantation, and may lead to strategies to reduce frailty and improve the medical care of individuals with advanced organ failure.