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Physical frailty after liver transplantation.
- Source :
-
American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons [Am J Transplant] 2018 Aug; Vol. 18 (8), pp. 1986-1994. Date of Electronic Publication: 2018 Mar 13. - Publication Year :
- 2018
-
Abstract
- Frailty is prevalent in liver transplant candidates, but little is known of what happens to frailty after liver transplantation. We analyzed data for 214 adult liver transplant recipients who had ≥1 frailty assessment using the Liver Frailty Index (LFI) at 3- (n = 178), 6- (n = 139), or 12- (n = 107) months posttransplant (higher values=more frail). "Frail" and "robust" were defined as LFI ≥4.5 and <3.2. Median pre-liver transplant LFI was 3.7, and was worse at 3 months (3.9; P = .02), similar at 6 months (3.7; P = .07), and improved at 12 months (3.4; P < .001). The percentage who were robust pre- and 3-, 6-, and 12-months posttransplant were 25%, 14%, 28%, and 37%; the percentage frail were 21%, 21%, 10%, and 7%. In univariable analysis, each 0.1 pretransplant LFI point more frail was associated with a decreased odds of being robust at 3- (odds ratio [OR] 0.75), 6- (OR 0.77), and 12-months (OR 0.90) posttransplant (P ≤ .001), which did not change substantially with multivariable adjustment. In conclusion, frailty worsens 3 months posttransplant and improves modestly by 12 months, but fewer than 2 of 5 patients achieve robustness. Pretransplant LFI was a potent predictor of posttransplant robustness. Aggressive interventions aimed at preventing frailty pretransplant are urgently needed to maximize physical health after liver transplantation.<br /> (© 2018 The American Society of Transplantation and the American Society of Transplant Surgeons.)
- Subjects :
- Aged
Cohort Studies
Female
Follow-Up Studies
Frailty diagnosis
Humans
Incidence
Male
Middle Aged
Prognosis
Risk Factors
United States epidemiology
End Stage Liver Disease surgery
Frailty epidemiology
Liver Transplantation methods
Postoperative Complications
Quality of Life
Severity of Illness Index
Subjects
Details
- Language :
- English
- ISSN :
- 1600-6143
- Volume :
- 18
- Issue :
- 8
- Database :
- MEDLINE
- Journal :
- American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons
- Publication Type :
- Academic Journal
- Accession number :
- 29380529
- Full Text :
- https://doi.org/10.1111/ajt.14675