Peer-Reviewed Publication
Am J Transplant2026August 25, 2026Journal Article
Performance-Based Frailty Tools Capture Distinct Risk Phenotypes in Kidney Transplant Candidates: A Comparative Analysis of FRAIL and SPPB.
Rucháma Verhoeff1, Frank E Hullekes2, Emily Jaffe3, Jennie L Cataldo4, Marcio A B C Rockenbach5, Bernardo C Bizzo5, Hannah M Pratt4, Paul Foster4, Sul A Lee6, Nicolas Melaragno7, Alexandria Warner3, Pitchapon Nissaisorakarn4, Nahel Elias3, Shimul A Shah3, Hannah M Gilligan4, Ron W F de Bruin8, Robert J Porte8, Leonardo V Riella9
1Center for Transplantation Sciences, Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; Erasmus MC Transplant Institute, Department of Surgery, Division of HPB & Transplant Surgery, Erasmus University Medical Center, Rotterdam, The Netherlands.
2Center for Transplantation Sciences, Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; Groningen Transplant Center, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
3Center for Transplantation Sciences, Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
4Department of Medicine, Nephrology Division, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
5Department of Radiology, Massachusetts General Hospital, Harvard Medical School, MA, USA; Mass General Brigham AI, Mass General Brigham, Boston, MA, USA.
6Division of Renal Medicine, Department of Medicine, UMass Memorial Medical Center, Worcester, MA, USA.
7Center for Transplantation Sciences, Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; Medical School, FMABC University Center, Santo André, Brazil.
8Erasmus MC Transplant Institute, Department of Surgery, Division of HPB & Transplant Surgery, Erasmus University Medical Center, Rotterdam, The Netherlands.
9Center for Transplantation Sciences, Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; Department of Medicine, Nephrology Division, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA. Electronic address: lriella@mgh.harvard.edu.
Abstract
Frailty predicts adverse outcomes in kidney transplant candidates, but it remains unclear whether different frailty tools identify the same or distinct at-risk patients. In this retrospective cohort study, 953 kidney transplant candidates listed between 2018 and 2022 underwent frailty assessment using both the FRAIL (Fatigue, Resistance, Ambulation, Illnesses, Weight Loss) scale and Short Physical…
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