Comprehensive review: Frailty in pancreas transplant candidates and recipients. Clin Transplant 2023 Feb;37(2):e14899
Date
01/03/2023Pubmed ID
36591953DOI
10.1111/ctr.14899Scopus ID
2-s2.0-85146338296 (requires institutional sign-in at Scopus site) 4 CitationsAbstract
Well-selected patients with kidney disease and diabetes mellitus who undergo simultaneous kidney-pancreas transplantation often experience dramatic improvements in quality of life and long-term survival compared to those who remain on medical therapy. Over the past several years the importance of frailty in the pancreas transplant candidate and recipient populations has grown. More patients with advanced age have entered the waitlist, and complications from prolonged diabetes, even in younger patients, have created increased evidence of risk for frailty. Given these concerns, and the broad challenges facing pancreas transplantation volumes overall, we generated this review to help establish the impact and implications. We summarize the interplay of immunological factors, aging, environmental factors, diabetes mellitus, and chronic kidney disease that put these patients at risk for frailty. We discuss its measurement and recommend a combination of two instruments (both well-validated and one entirely objective). We describe the outcomes for patients before and after pancreas transplantation who may have frailty, and what interventions can be taken to mitigate its effects. Broader investigation into frailty in the pancreas transplant population is needed to better understand how to select patients for pancreas transplantation and to how manage its consequences thereafter.
Author List
Parsons RF, Tantisattamo E, Cheungpasitporn W, Basu A, Lu Y, Lentine KL, Woodside KJ, Singh N, Scalea J, Alhamad T, Dunn TB, Rivera FHC, Parajuli S, Pavlakis M, Cooper MAuthors
Matthew Cooper MD Chief, Director, Professor in the Surgery department at Medical College of WisconsinTy Blink Dunn MD Professor in the Surgery department at Medical College of Wisconsin
MESH terms used to index this publication - Major topics in bold
Diabetes Mellitus, Type 1Frailty
Graft Survival
Humans
Kidney Transplantation
Pancreas Transplantation
Quality of Life
