Identifying how frailty affects older people receiving a kidney transplant

Edwina, Michelle and the team looked at 210 patients over the age of 60 who were waiting for a kidney transplant. They investigated whether having frailty impacted mental and physical health in the months before and following kidney transplant surgery. This included questionnaires to assess physical and mental quality of life, symptom burden, treatment satisfaction and the impact of their condition on their everyday life. 

Edwina, Michelle and the team also looked at medical data for these patients to see if people with frailty were more at risk of health problems related to transplant surgery itself, such as infection.    

The majority of participants reported their mental and physical health decreased following surgery. Participants who were frail or vulnerable to frailty reported worse symptom burden, mental health and depression following transplant. However, for most, the burden of their symptoms and satisfaction with their treatment improved after surgery and reached a better level than before transplant by one year.  

Following transplant surgery, frail and vulnerable to frailty participants were more likely to have a kidney that took longer to begin working properly, which can mean a temporary return to dialysis, and were more likely to spend longer in hospital recovering from surgery. 

Longer term function of the transplant, measured after a year, was also not as good in frail and vulnerable to frailty participants. However, in most cases a kidney transplant did stabilise the declining physical health of people who were frail and vulnerable to frailty.