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

被引:20
作者
Kobashigawa, Jon [1 ]
Shah, Palak [2 ]
Joseph, Susan [3 ]
Olymbios, Michael [1 ]
Bhat, Geetha [4 ]
Dhital, Kumud [5 ]
Eisen, Howard [6 ]
Kransdorf, Evan [1 ]
Patel, Jignesh [1 ]
Skorka, Rafael [1 ]
Pinney, Sean [7 ]
Wilson, Michael E. [8 ]
Hall, Shelley [3 ]
机构
[1] Cedars Sinai Smidt Heart Inst, Los Angeles, CA 90048 USA
[2] Inova Heart & Vasc Inst, Falls Church, VA USA
[3] Baylor Univ, Med Ctr, Dallas, TX USA
[4] Advocate Christ Med Ctr, Oak Lawn, IL USA
[5] St Vincents Hosp, Sydney, NSW, Australia
[6] Drexel Univ, Philadelphia, PA 19104 USA
[7] Mt Sinai Hosp, New York, NY 10029 USA
[8] Mayo Clin, Rochester, MN USA
关键词
clinical research; practice; heart disease; metabolic; heart failure; injury; heart transplantation; cardiology; VENTRICULAR ASSIST DEVICE; ACTIVITY STATUS INDEX; CARDIAC REHABILITATION; HOSPITALIZED-PATIENTS; FUNCTIONAL-CAPACITY; CLINICAL-OUTCOMES; PROGNOSTIC VALUE; FAILURE PATIENTS; OLDER PATIENTS; PREVALENCE;
D O I
10.1111/ajt.16207
中图分类号
R61 [外科手术学];
学科分类号
摘要
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.
引用
收藏
页码:636 / 644
页数:9
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