Clinical Significance of Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio in Liver Transplantation

Abstract

Objective: Liver transplantation has been reported to be a predictor of patient survival in acute coronary syndrome and various malignancies, including hepatocellular carcinoma (HCC). In a previous study, it was demonstrated that high Platelet-to-Lymphocyte Ratio (PLR) values before treatment are an independent prognostic factor predicting poor survival in patients with large HCC. We aimed to investigate whether preoperative neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and thrombocyte count are prognostic factors for posttransplantation mortality or graft function in patients who underwent liver transplantation in the clinic.
 Material and Methods: The data of 40 patients who underwent liver transplantation in the clinic during January 2018–December 2020 were retrospectively analyzed and included in the study.
 Results: The mean age of the 40 patients included in the study was 51.1 ± 11.7 years. Of these, 27 (67.5%) were male, and 13 (32.5%) were female. Living-donor liver transplantation was performed in 33 patients, whereas cadaveric liver transplantation was performed in seven patients. The mean ejection fraction (EF) was 56.7% ± 3.2%, and the mean model for end-stage liver disease score was 22.4 ± 5.4. After one year of follow-up, 10 out of 40 patients (25%) died after orthotopic liver transplantation. The mean preoperative neutrophil count was found to be 5.7 ± 2.4 × 109/l in non-surviving patients and 3.1 ± 2.05 × 109/l in surviving patients. It was found that mortality increased in patients with high preoperative neutrophil values (NLR > 3.7, p < 0.001) and preoperative platelet count (<79.52 × 109/L, p < 0.001).
 Conclusion: Preoperative neutrophilia, thrombocytopenia and high NLR values may predict poor prognosis in patients undergoing OLT.