A New Approach to Evaluating Frailty in Solid Organ 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 older individuals with advanced organ failure.

Research Results

Project findings and information will be updated on a continual basis.

About the Project

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 living with frailty, which may lead to poor outcomes after transplantation. Prior to this study, we did not know how best to measure frailty in organ transplant candidates and recipients. Without appropriate tools to measure frailty, we do not know if patients living with frailty got as much benefit from transplantation as individuals not living with frailty, or how to help patients living with frailty with organ failure have longer and better lives before and after transplantation though exercise or other treatments.

The objective of this study was to develop and test the usefulness of a new tool to measure frailty in transplant candidates for heart, lung, kidney or liver transplantation. Using the cumulative deficits model, we determined that increasing frailty is associated with less likelihood of transplant listing and higher risks for transplant waitlist death or delisting and post-transplant death.

Project Team

Principal Investigator:

Lianne Singer, MD, FRCPC — University Health Network

Co-Investigators:

Susan Abbey, MD, FRCPC — University Health Network

Sang Joseph Kim, MD, PhD, FRCPC — University Health Network

Jane MacIver, RN(NP), PhD — University Health Network

Sunita Mathur, PT, PhD — University of Toronto

Eberhard Renner, MD — University Health Network

Kenneth Rockwood, MD, FRCPC — Dalhousie University

Heather Ross, MD, MSc, FRCPC — University Health Network

Knowledge Users and Partners:

Multi-Organ Transplant Program, University Health Network

Trillium Gift of Life Network

Project Contact: Lianne Singer — lianne.singer@uhn.ca

FRA 2015-B-13