The FRAILMar trial addresses a growing challenge in kidney transplantation: how to optimize candidates, particularly those with frailty, during the vulnerable and oftentimes prolonged pretransplant period to mitigate postoperative risks. Defined by reduced physiologic reserve and increased vulnerability to stressors, frailty is highly prevalent in individuals with end-stage kidney disease. Frailty is independently associated with increased risks of pre–1-3 and post–kidney transplant (KT) adverse outcomes.