An Initiative to Assess Frailty and Functional Status in Cardiac Transplant Candidates

Area of Science:

• Cardiology
• Rehabilitation Medicine
• Transplantation Surgery

Background:

• Systematic frailty evaluation is recommended for heart transplant candidates.
• Implementing frailty assessments can be challenging in clinical practice.

Purpose of the Study:

• To assess the implementation of frailty assessment for inpatient heart transplant candidates.
• To describe frailty characteristics and prehabilitation plan content in this population.

Main Methods:

• Retrospective review of hospitalized heart transplant candidates with PM&R consultation (10/30/23 - 1/6/25).
• Assessment of objective frailty measures (mFFP, SPPB), correlation to transplant listing, and prehabilitation plan content.
• Multidisciplinary team assessments interpreted by a PM&R physician.

Main Results:

• All 56 inpatient consults included completed frailty assessments.
• 32% had frail mFFP scores; 25% had frail SPPB scores.
• No patients with frail SPPB scores were listed for transplantation.
• All patients received prehabilitation plans covering therapy/exercise, nutrition, and resilience.

Conclusions:

• A coordinated, multidisciplinary frailty evaluation for heart transplant candidates is feasible under PM&R leadership.
• Frailty assessment effectively informs transplant selection committees for risk stratification.
• Prehabilitation plans can be created to improve patients' functional status.