Change in frailty status in the 12 months following solid organ transplantation: a systematic review and meta-analysis

Bevan, Anna, Avery, Jenny, Cheah, Hoe Leong, Carter, Ben and Hewitt, Jonathan ORCID: https://orcid.org/0000-0002-7924-1792 2025. Change in frailty status in the 12 months following solid organ transplantation: a systematic review and meta-analysis. Age and Ageing 54 (1) , afae283. 10.1093/ageing/afae283

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Abstract

Objectives To investigate if frailty status alters following solid organ transplantation (lung, liver, kidney and heart) without rehabilitation intervention. Research design and methods Studies published between 1 January 2000 and 30 May 2023 were searched across five databases. Studies measuring frailty, using a validated or established frailty measure, pre- and post-transplant were included. Narrative synthesis was used to describe the included studies according to the time post-transplant and according to solid organ group. Where data allowed a meta-analysis was conducted to compare frailty prevalence pre- and 6–12 months post-transplant across studies. Results Twelve studies were included in this review (6 kidney transplant, 2 liver transplant, 3 lung transplant and 1 heart transplant), with a total of 3065 transplant recipients with 62% being male. The mean age across studies was 51.35 years old. When narratively synthesised after an initial worsening of frailty immediately post-transplant, there appears to be a significant improvement in frailty by 3 months post-transplant that is sustained by 6 to 12 months following solid organ transplantation. Five studies were included in the meta-analysis which demonstrated an odds ratio = 0.27 (95% CI, 0.12, 0.59, P = .001, ${I}^2$ = 82%) for frailty prevalence post-solid organ transplantation (SOT) compared to frailty prevalence pre-SOT. When the single paper deemed to be of poor quality was removed the remaining four studies demonstrated a reduced odds ratio of being frail at 6–12 months post-transplant (OR 0.45 (95% CI, 0.32, 0.65, P = .001, ${I}^2$ = 13%). Conclusions Transplant may be associated with a reversal in frailty, although heterogeneity was demonstrated across studies.

Item Type:	Article
Date Type:	Publication
Status:	Published
Schools:	Medicine
Additional Information:	License information from Publisher: LICENSE 1: URL: https://creativecommons.org/licenses/by/4.0/, Start Date: 2025-01-08
Publisher:	Oxford University Press
ISSN:	0002-0729
Date of First Compliant Deposit:	17 January 2025
Last Modified:	17 Jan 2025 11:30
URI:	https://orca.cardiff.ac.uk/id/eprint/175343

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