This session will explore the role of frailty and other aging-related metrics in older adults undergoing kidney transplantation. The discussion will begin with an overview of the importance of assessing measures of aging—such as frailty, physical function, and cognitive function—during the kidney transplant evaluation process. It will also address how frailty and cognitive function may change after transplantation and how these trajectories influence key post-transplant outcomes. Particular attention will be given to the association between frailty and adverse outcomes, including mortality, graft loss, early hospital readmissions, and cognitive decline among older kidney transplant recipients.

The session will also examine the bi-directional relationship between frailty and infections in older transplant recipients. Common infections—such as herpes zoster, influenza, and recurrent urinary tract infections—will be discussed in the context of how frailty may increase susceptibility to infection and how infections, in turn, may worsen frailty and contribute to poor post-transplant outcomes. Preventive strategies, including infection prophylaxis, vaccination, and considerations regarding vaccine effectiveness in older adults, will also be reviewed.

In addition, the session may highlight commonly used frailty assessment tools that have been applied in transplant populations. These include the Fried Frailty Phenotype and several frailty indices, such as the Rockwood 20-Item Frailty Index, the Lekan Frailty Score, and the Modified Frailty Index. The overview will emphasize how these tools have been used in research and clinical practice to evaluate frailty and better understand its relationship with infections and other post-transplant outcomes in older organ transplant recipients.

• Learners will develop an understanding of different frailty assessment tools that can be utilized both for clinical evaluations as well as for purposes of research.
• Understand the impact of frailty on post-transplant outcomes including mortality and graft-loss in older adults.
• How infections can further worsen the trajectory of frailty and post-transplant outcomes in the frail elder organ transplant recipients.
• The frailty symposium highlights the urgent and unmet needs of future studies involving frailty and infections.