Frailty as a predictive metric for pre- and post-transplant outcomes

Article: Frailty as an Outcome Measurement Before and After Liver Transplant

Frailty is a known risk factor for negative surgical outcomes, and the Liver Frailty Index (LFI) has been shown to predict mortality in patients awaiting liver transplants. Despite this, neither a diagnosis of frailty nor a patient’s LFI holds any weight when determining their position on liver transplant waitlists.

The aim of this article was to assess frailty and the LFI’s ability to predict pre- and post-transplant outcomes.

Key learnings:

Frailty predicts both waitlist mortality and post-transplant quality of life. As such, it should be incorporated into the waitlist consideration to prioritise patients on track for further liver decompensation and overall physical decline. Both frailty and improvement in quality of life should also be regarded as potent outcome quality metrics. Moreover, investments should be made into prehabilitation or early postoperative rehabilitation efforts as a means to both improve compliance and relieve the long-term economic strain of readmissions on hospitals.

Reviewed by: S. Duarte

Authors: Whitrock JN, Lemon KHK and Shah SA

Published in: JAMA Surgery 2022