Older patients are more often being considered for kidney transplantation, however many candidates are on the waitlist for several years. We sought to evaluate the impact of frailty in the context of previously established transplant candidacy.

Materials: The Short Physical Performance Battery (SPPB) is an established tool used to assess physical performance of the lower extremities with which meta-analysis has been linked to all-cause mortality when the score was <10

Methods: Waitlisted patients 65 and older were assessed using the SPPB and scores were compared to real time physician assessments. Clinical data including demographics, transplant type and comorbidities were collected. Statistical analysis performed using JMP Pro 12. Pearson chi-squared, t test as appropriate for categorical or numeric variables.

Results: Out of 56 patients ages 65 to 76, older patients (70-76) had lower SPPB scores (mean 6) compared with patients 65-69 (mean 7.8). There was a trend towards more diabetes in the older group 67% vs. 49% (p=0.187).

SPPB scores correlated well with physician assessments as most patients removed from the waitlist had an SPPB of ≤ 6. Of those with SPPB < 7, 32% died or were removed from the waitlist vs. 7% of those with SPPB ≥ 7 (p= 0.019)

Diabetes was more prevalent among patients with SPPB < 7 (68%) vs patients with SPPB ≥ 7 (43%) but this finding did not reach statistical significance (p=0.060).

In the older group the highest SBBP scores were observed in patients with a BMI of 26-30, followed by BMI > 30 and lowest scores in BMI of 19-25, in contrast to the younger group where the lowest scores were in the BMI >30 group.

Table 1. Association of frailty with clinical characteristics

Conclusion: There was an excellent correlation between SPPB scores and death and/or removal from the transplant waitlist which suggests frailty assessments can be used as an objective measure for candidate selection, risk stratification and prediction of outcomes. We will further expand on this study and attempt to validate our results using a larger number of patients with a broader age range, 55 years and older.

CITATION INFORMATION: Abdalla B., Hale-Durbin B., Schaenman J., Lee C., Danovitch G. Frailty Assessment Pilot Study in Older Kidney Transplant Recipients Am J Transplant. 2017;17 (suppl 3).

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