Deconditioning or biology? Triaging frailty in lung transplant candidates

Extract The essential question in evaluating lung transplant candidates is whether that individual will benefit from transplantation. While lung transplantation is associated with improvements in physical function, quality of life, and survival for appropriate candidates, inappropriate selection is not only harmful to the candidate but to others on the waitlist. Understanding who stands to benefit from lung transplantation requires comprehensive assessment of potential risk factors. Some of these risk factors, such as age, organ dysfunction, or malignancy, cannot be reversed. Addressing modifiable risk factors, such as obesity, malnutrition, coronary artery disease, infections, or gastro-oesophageal reflux disease can allow otherwise marginal candidates to succeed [1].