Frailty in Lung Transplant Candidates Predicts Post-Transplant Outcomes: A Multicenter Study

Document Type

Conference Proceeding

Publication Date

9-2025

Publication Title

American Journal of Transplantation

Abstract

Purpose: As the complexity, age, and comorbidity burden of lung transplant (LT) candidates continues to increase, there has been further interest in frailty evaluation to predict post-LT outcomes. We set out to determine whether chart-based frailty assessment approach could predict outcomes after LT. Methods: The AST IDCOP Older Patient Working Group was leveraged to create a large cohort to assess chart-based assessment of frailty using a modified Rockwood frailty index (mFI) and the Lekan frailty risk score (FRS). We additionally evaluated multimorbidity using the Charlson Comorbidity Index (CCI). Numeric scores were binarized into high versus low groups for analysis. Results: Five transplant centers entered patient data to create a total cohort of 86 patients who underwent LT (Table). Median patient age was 63 years (range 29-74) and median LAS score was 44 (range 32-53). 67% of patients were male and 90% were white race. Median length of stay after transplant was 18 days, and median total hospital time in the first year post-transplant was 25 days. 69% of patients were readmitted, and 82% experienced at least one episode of infection (range 1-7) in the first year post-LT. Frailty scores were not associated with patient age alone. mFI and CCI were significantly associated with readmission to hospital post-transplant (p=0.035 and p=0.025, respectively). Total hospital time was significantly associated with CCI (p=0.044), with median 32.5 days for high and 22.5 days for low scores by median CCI. FRS was significantly associated with the number of post-LT infections (p=0.016). Patient age or LAS score were not predictive of clinical outcomes. Conclusions: Frailty and multimorbidity assessments can predict post-LT outcomes. Comorbidity and function-based scores were able to predict readmission and total hospital time in the first post-LT year, while FRS which includes laboratory values was associated with infections after LT. Evaluation of the full cohort will include investigation of association between infection types and frailty. The ability to automate frailty assessment utilizing chart-based methods holds promise for pre-transplant patient evaluation and risk stratification.

Volume

25

Issue

8 Suppl 1

First Page

S505

Last Page

S505

Comments

American Society of Transplantation World Transplant Congress, August 2-6, 2025, San Francisco, CA

ISSN

1600-6143

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