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Frailty assessment and candidate optimization before cardiothoracic transplantation
Antoine Premachandra1,2, Jacob Klapper3, Jonathan Messika4
1Department of Anesthesiology, Foch Hospital, Suresnes, France.
JHLT Open
|February 16, 2026
Summary
Frailty significantly impacts thoracic transplant patients with end-stage cardiopulmonary disease. Addressing frailty before heart and lung transplant can improve outcomes and reduce mortality.
Area of Science:
- Gerontology
- Cardiology
- Pulmonology
Background:
- Frailty is a growing concern in aging populations undergoing thoracic transplantation.
- End-stage cardiopulmonary disease exacerbates the lack of physiologic reserve in these patients.
- Frailty is linked to adverse perioperative outcomes in heart and lung transplant recipients.
Purpose of the Study:
- To review the definition and measurement of frailty in thoracic transplant candidates.
- To explore interventions for managing frailty contributors in this population.
- To emphasize the importance of pre-transplant frailty assessment and treatment.
Main Methods:
- This is a review article.
- Literature search on frailty, thoracic transplantation, and perioperative outcomes.
- Synthesis of current evidence on frailty assessment and management.
Main Results:
- Frailty assessment is crucial for identifying patients with diminished physiologic reserve.
- Interventions targeting frailty can potentially improve perioperative outcomes.
- Early identification and treatment of frailty are key to preventing complications.
Conclusions:
- Frailty is a critical determinant of outcomes in thoracic transplant recipients.
- Proactive management of frailty before heart and lung transplantation is essential.
- Addressing frailty can mitigate comorbidity and mortality risks in the transplant population.
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