Frailty in liver transplantation: An expert opinion statement from the American Society of Transplantation Liver and Intestinal Community of Practice.

Published

Journal Article

Frailty has emerged as a powerful predictor of outcomes in patients with cirrhosis and has inevitably made its way into decision making within liver transplantation. In an effort to harmonize integration of the concept of frailty among transplant centers, the AST and ASTS supported the efforts of our working group to develop this statement from experts in the field. Frailty is a multidimensional construct that represents the end-manifestation of derangements of multiple physiologic systems leading to decreased physiologic reserve and increased vulnerability to health stressors. In hepatology/liver transplantation, investigation of frailty has largely focused on physical frailty, which subsumes the concepts of functional performance, functional capacity, and disability. There was consensus that every liver transplant candidate should be assessed at baseline and longitudinally using a standardized frailty tool, which should guide the intensity and type of nutritional and physical therapy in individual liver transplant candidates. The working group agreed that frailty should not be used as the sole criterion for delisting a patient for liver transplantation, but rather should be considered one of many criteria when evaluating transplant candidacy and suitability. A road map to advance frailty in the clinical and research settings of liver transplantation is presented here.

Full Text

Duke Authors

Cited Authors

  • Lai, JC; Sonnenday, CJ; Tapper, EB; Duarte-Rojo, A; Dunn, MA; Bernal, W; Carey, EJ; Dasarathy, S; Kamath, BM; Kappus, MR; Montano-Loza, AJ; Nagai, S; Tandon, P

Published Date

  • July 2019

Published In

Volume / Issue

  • 19 / 7

Start / End Page

  • 1896 - 1906

PubMed ID

  • 30980701

Pubmed Central ID

  • 30980701

Electronic International Standard Serial Number (EISSN)

  • 1600-6143

Digital Object Identifier (DOI)

  • 10.1111/ajt.15392

Language

  • eng

Conference Location

  • United States