Evidence map›Paper›PMID 36925382›Full record

ArticleThe Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation2023

Development of the Lung Transplant Frailty Scale (LT-FS).

Jonathan P Singer, Jason D Christie, Joshua M Diamond, Michaela A Anderson, Luke A Benvenuto, Ying Gao, Selim M Arcasoy, David J Lederer, Daniel Calabrese, Ping Wang and 21 more

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.

0numbers the graph read from it
0cells of the map it votes in
14citing papers in PubMed
7.9field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

14 citing papers in PubMed, 25 citations in OpenAlex.

  1. Article
  2. Review
  3. Article
  4. Article
  5. Article
  6. Article
  7. Frailty in lung transplant recipients is associated with anemia and telomere dysfunction but independent of epigenetic age.American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons · 2025
    Article
  8. Characteristics and Outcomes of 1500 Lung Transplantations in the Leuven Lung Transplant Program: Turning Past Lessons Into Tomorrow's Foundations.Transplant international : official journal of the European Society for Organ Transplantation · 2025
    Article
  9. The Path Forward: A Review on Enhanced Recovery After Cardiothoracic Transplantation.Transplant international : official journal of the European Society for Organ Transplantation · 2025
    Review
  10. Article
  11. Article
  12. Article
  13. Article
  14. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

31 authors at 5 institutions in 1 country.

Jonathan P SingerDivision of Pulmonary and Critical Care, Department of Medicine, School of Medicine, University of California, San Francisco CA, USA. Electronic address: jon.singer@ucsf.edu.
Jason D ChristieDivision of Pulmonary and Critical Care, Department of Medicine, School of Medicine, University of Pennsylvania, Philadelphia, Philadelphia, PA, USA.
Joshua M DiamondDivision of Pulmonary and Critical Care, Department of Medicine, School of Medicine, University of Pennsylvania, Philadelphia, Philadelphia, PA, USA.
Michaela A AndersonDivision of Pulmonary and Critical Care, Department of Medicine, School of Medicine, University of Pennsylvania, Philadelphia, Philadelphia, PA, USA.
Luke A BenvenutoDivision of Pulmonary, Allergy and Critical Care Medicine, Columbia University Medical Center, Villanova, Pennsylvania.
Ying GaoDivision of Pulmonary and Critical Care, Department of Medicine, School of Medicine, University of California, San Francisco CA, USA.
Selim M ArcasoyDivision of Pulmonary, Allergy and Critical Care Medicine, Columbia University Medical Center, Villanova, Pennsylvania.
David J LedererRegeneron Pharmaceuticals, Tarrytown, New York.
Daniel CalabreseDivision of Pulmonary and Critical Care, Department of Medicine, School of Medicine, University of California, San Francisco CA, USA; Medical Service, San Francisco VA Health Care System, San Francisco, California.
Ping WangDivision of Pulmonary and Critical Care, Department of Medicine, School of Medicine, University of California, San Francisco CA, USA.
Steven R HaysDivision of Pulmonary and Critical Care, Department of Medicine, School of Medicine, University of California, San Francisco CA, USA.
Jasleen KukrejaDivision of Pulmonary and Critical Care, Department of Medicine, School of Medicine, University of California, San Francisco CA, USA.
Aida VenadoDivision of Pulmonary and Critical Care, Department of Medicine, School of Medicine, University of California, San Francisco CA, USA.
Nicholas A KolaitisDivision of Pulmonary and Critical Care, Department of Medicine, School of Medicine, University of California, San Francisco CA, USA.
Lorriana E LeardDivision of Pulmonary and Critical Care, Department of Medicine, School of Medicine, University of California, San Francisco CA, USA.
Rupal J ShahDivision of Pulmonary and Critical Care, Department of Medicine, School of Medicine, University of California, San Francisco CA, USA.
Mary Ellen KleinhenzDivision of Pulmonary and Critical Care, Department of Medicine, School of Medicine, University of California, San Francisco CA, USA.
Jeffrey GoldenDivision of Pulmonary and Critical Care, Department of Medicine, School of Medicine, University of California, San Francisco CA, USA.
Legna BetancourtDivision of Pulmonary and Critical Care, Department of Medicine, School of Medicine, University of California, San Francisco CA, USA.
Michelle OysterDivision of Pulmonary and Critical Care, Department of Medicine, School of Medicine, University of Pennsylvania, Philadelphia, Philadelphia, PA, USA.
Derek ZaleskiDivision of Pulmonary and Critical Care, Department of Medicine, School of Medicine, University of Pennsylvania, Philadelphia, Philadelphia, PA, USA.
Joe AdlerDivision of Pulmonary and Critical Care, Department of Medicine, School of Medicine, University of Pennsylvania, Philadelphia, Philadelphia, PA, USA.
Laurel KalmanDivision of Pulmonary and Critical Care, Department of Medicine, School of Medicine, University of Pennsylvania, Philadelphia, Philadelphia, PA, USA.
Priya BalarDivision of Pulmonary and Critical Care, Department of Medicine, School of Medicine, University of Pennsylvania, Philadelphia, Philadelphia, PA, USA.
Shreena PatelDivision of Pulmonary, Allergy and Critical Care Medicine, Columbia University Medical Center, Villanova, Pennsylvania.
Nikhila MedikondaDivision of Pulmonary and Critical Care, Department of Medicine, School of Medicine, University of California, San Francisco CA, USA.
Brittany KoonsCollege of Nursing, Villanova University, Villanova, PA, USA.
Michael TevaldRegeneron Pharmaceuticals, Tarrytown, New York.
Kenneth E CovinskyDivision of Geriatrics, Department of Medicine, University of California, San Francisco, California.
John R GreenlandDivision of Pulmonary and Critical Care, Department of Medicine, School of Medicine, University of California, San Francisco CA, USA; Medical Service, San Francisco VA Health Care System, San Francisco, California.
Patti K KatzDivision of Rheumatology, Department of Medicine, University of California, San Francisco, California.
University of California, San Francisco · USUniversity of Pennsylvania · USColumbia University Irving Medical Center · USRegeneron (United States) · USVillanova University · US

Funding

Long Term Follow up of the Lung Transplant Outcomes Group CohortU01HL145435 · NHLBI · UNIVERSITY OF PENNSYLVANIA · PI CHRISTIE, JASON D, PALMER, SCOTT M · 2019 to 2025
$10.2M
Frailty and patient centered outcomes in candidates for lung transplantationR01HL134851 · NHLBI · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI SINGER, JONATHAN PAUL · 2017 to 2021
$3.4M
The impact of body composition on peri-operative and patient-centered outcomes in lung transplantation.U01HL163242 · NHLBI · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI Jonathan Paul Singer · 2022 to 2026
$2.8M
Telomere Dysfunction as a cause of Chronic Lung Allograft DysfunctionR01HL151552 · NHLBI · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI GREENLAND, JOHN · 2020 to 2024
$1.6M
Mentored Patient Oriented Research in Lung TransplantationK24HL115354 · NHLBI · UNIVERSITY OF PENNSYLVANIA · PI CHRISTIE, JASON D · 2012 to 2021
$1.2M
The effects of lung transplantation on lung disease related disabilitiesF32HL107003 · NHLBI · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI SINGER, JONATHAN PAUL · 2011 to 2011
$63k
Natural killer cells in pulmonary ischemia-reperfusion injuryIK2BX005301 · VA · VETERANS AFFAIRS MED CTR SAN FRANCISCO · PI Daniel Calabrese · 2021 to 2026
–
Cytomegalovirus Immune Responses in Chronic Lung Allograft Dysfunction PathogenesisI01CX002011 · VA · VETERANS AFFAIRS MED CTR SAN FRANCISCO · PI GREENLAND, JOHN · 2020 to 2025
–
BLRD VA IK2 BX005301CSRD VA I01 CX002011NHLBI NIH HHS F32 HL107003NHLBI NIH HHS K24 HL115354NHLBI NIH HHS R01 HL134851NHLBI NIH HHS R01 HL151552NHLBI NIH HHS U01 HL145435NHLBI NIH HHS U01 HL163242
6 · The paper itself

Abstract

backgroundExisting measures of frailty developed in community dwelling older adults may misclassify frailty in lung transplant candidates. We aimed to develop a novel frailty scale for lung transplantation with improved performance characteristics.

methodsWe measured the short physical performance battery (SPPB), fried frailty phenotype (FFP), Body Composition, and serum Biomarkers representative of putative frailty mechanisms. We applied a 4-step established approach (identify frailty domain variable bivariate associations with the outcome of waitlist delisting or death; build models sequentially incorporating variables from each frailty domain cluster; retain variables that improved model performance ability by c-statistic or AIC) to develop 3 candidate "Lung Transplant Frailty Scale (LT-FS)" measures: 1 incorporating readily available clinical data; 1 adding muscle mass, and 1 adding muscle mass and research-grade Biomarkers. We compared construct and predictive validity of LT-FS models to the SPPB and FFP by ANOVA, ANCOVA, and Cox proportional-hazard modeling.

resultsIn 342 lung transplant candidates, LT-FS models exhibited superior construct and predictive validity compared to the SPPB and FFP. The addition of muscle mass and Biomarkers improved model performance. Frailty by all measures was associated with waitlist disability, poorer HRQL, and waitlist delisting/death. LT-FS models exhibited stronger associations with waitlist delisting/death than SPPB or FFP (C-statistic range: 0.73-0.78 vs. 0.57 and 0.55 for SPPB and FFP, respectively). Compared to SPPB and FFP, LT-FS models were generally more strongly associated with delisting/death and improved delisting/death net reclassification, with greater improvements with increasing LT-FS model complexity (range: 0.11-0.34). For example, LT-FS-Body Composition hazard ratio for delisting/death: 6.0 (95%CI: 2.5, 14.2), SPPB HR: 2.5 (95%CI: 1.1, 5.8), FFP HR: 4.3 (95%CI: 1.8, 10.1). Pre-transplant LT-FS frailty, but not SPPB or FFP, was associated with mortality after transplant.

conclusionsThe LT-FS is a disease-specific physical frailty measure with face and construct validity that has superior predictive validity over established measures.

Indexed as

FrailtyLung TransplantationBiomarkersHumansPhenotypeProspective StudiesBiomarkersbiomarkerbody compositionfrailtylung transplantation

Identifiers

PMID36925382
PMCPMC11022684
OpenAlexW4321368149

What Socratic holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.