Frailty has a significant influence on postoperative complications after kidney transplantation—a prospective study on short-term outcomes

Abstract

Currently, there are no tools to predict postsurgery outcome after kidney transplantation. This study assesses whether frailty influence 30-day postoperative complications after kidney transplantation. One-hundred and fifty kidney transplantations were prospectively included. Frailty was assessed using a frailty indicator, consisting of 15 questions, covering most domains of functioning. Postoperative complications were measured by the Comprehensive Complication Index (CCI). Using a linear regression model, 30-day postoperative complications and frailty correlation were adjusted for confounders, including sex, age, ASA Score, Charlson Comorbidity Index, hypertension, BMI, smoking, dialysis, duration of dialysis, type of transplantation, and retransplantation. The mean frailty score was 2.07(±1.6) and 23 patients were classified as frail (GFI ≥4). The mean CCI-score was 18(±15.6), the mean CCI-score for “frail” patients 30.1(±17.2) compared to 15.5 (±14.2) for “non-frail” patients (N = 116). In a regression analysis, a significant relationship between CCI-score and frailty (β = 13.3; 95% CI 5.7–20.9; P = 0.0007) and transplantation type (β = 4.9; 95% CI: 0.72–9.16; P = 0.02) was found, independent of confounders. In conclusion, frailty and type of transplantation are independent factors associated with an increased risk of postoperative complications.