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Frailty in heart transplantation: Report from the heart workgroup of a consensus conference on frailty
Journal article   Open access   Peer reviewed

Frailty in heart transplantation: Report from the heart workgroup of a consensus conference on frailty

Jon Kobashigawa, Palak Shah, Susan Joseph, Michael Olymbios, Geetha Bhat, Kumud Dhital, Howard Eisen, Evan Kransdorf, Jignesh Patel, Rafael Skorka, …
American journal of transplantation, v 21(2), pp 636-644
Feb 2021
PMID: 32659872
url
https://doi.org/10.1111/ajt.16207View
Published, Version of Record (VoR)CC BY-NC-ND V4.0 Open

Abstract

clinical research/ practice heart disease heart disease: metabolic heart failure/ injury heart transplantation/ cardiology
A consensus conference on frailty in solid organ transplantation took place on February 11, 2018, to discuss the latest developments in frailty, adopt a standardized approach to assessment, and generate ideas for future research. The findings and consensus of the Frailty Heart Workgroup (American Society of Transplantation's Thoracic and Critical Care Community of Practice) are presented here. Frailty is defined as a clinically recognizable state of increased vulnerability resulting from aging‐associated decline in reserve and function across multiple physiologic systems such that the ability to cope with every day or acute stressors is compromised. Frailty is increasingly recognized as a distinct biologic entity that can adversely affect outcomes before and after heart transplantation. A greater proportion of patients referred for heart transplantation are older and have more complex comorbidities. However, outcomes data in the pretransplant setting, particularly for younger patients, are limited. Therefore, there is a need to develop objective frailty assessment tools for risk stratification in patients with advanced heart disease. These tools will help to determine appropriate recipient selection for advanced heart disease therapies including heart transplantation and mechanical circulatory support, improve overall outcomes, and help distinguish frailty phenotypes amenable to intervention. This article reports the Frailty Heart Workgroup's deliberations regarding standardization of frailty nomenclature and assessment as well as the approach to frailty in heart failure and heart transplant patients.

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Collaboration types
Domestic collaboration
International collaboration
Web of Science research areas
Surgery
Transplantation
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