Neutrophil Lymphocyte Ratio can Preempt Development of Sepsis After Adult Living Donor Liver Transplantation

Sarin, S.K.; Pamecha, Viniyendra; Sinha, Piyush Kumar; Patil, Nilesh; Mahapatra, Nihar R.

doi:10.1016/j.jceh.2021.11.008

Cited by 4 publications

(4 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Moreau et al [26], showed that ACLF patients with NLR values >6.5 on admission displayed a higher risk of 3 months mortality. Previous reports showed similar results in liver transplant patients [27], and patients experiencing uncontrolled ascites or variceal bleeding [28]. A recent meta-analysis found no significant difference in cumulative NLR levels depending on whether or not cirrhotic patients had an infection [29].…”

Section: Discussionmentioning

confidence: 63%

Hematological ratios in patients with acute decompensation and acute-on-chronic liver failure: prognostic factors

Lashen,

Salem,

Ibrahim

et al. 2024

European Journal of Gastroenterology &Amp; Hepatology

View full text Add to dashboard Cite

Background and aims Acute-on-chronic liver failure (ACLF) is the most severe form of acutely decompensated cirrhosis and is characterized by the presence of intense systemic inflammation. Leucocyte quantification can serve as an indirect indicator of systemic inflammation. In our study, we investigated the predictive value of hematological ratios (neutrophils to lymphocytes, monocyte to lymphocytes, platelets to lymphocytes, lymphocytes to C-reactive protein, and neutrophils to lymphocytes and platelets) in acute decompensation (AD) and ACLF patients and their relation to disease severity and early mortality. Patients and methods We included 60 patients with ACLF and AD, and 30 cirrhotic controls. Clinical data were collected, and survival was followed for 1 and 6 months. Blood samples were analyzed at admission for differential leucocytes and assessed for liver and renal function tests. The leukocyte ratios were calculated and compared, and their correlation with liver function indicators and prognosis was assessed. Results All ratios were significantly higher in AD and ACLF patients compared to control (except for lymphocyte to C-reactive protein ratio which was significantly lower), and were positively correlated with Child-Pugh score, model for end-stage liver disease (MELD)-Na, and ACLF severity scores. Multivariate regression revealed that neutrophil to lymphocyte ratio, monocyte to lymphocyte ratio, and MELD-Na were independent prognostic factors of 1-month and 6-month mortality. A unique prognostic nomogram incorporating MELD-Na, neutrophil to lymphocyte ratio, and monocyte to lymphocyte ratio could be proposed for predicting prognosis in AD and ACLF patients. Conclusions Cheap, easy, and noninvasive hematological ratios are introduced as a tool for early identification and risk stratification of AD and ACLF patients.

show abstract

Section: Discussionmentioning

confidence: 63%

Hematological ratios in patients with acute decompensation and acute-on-chronic liver failure: prognostic factors

Lashen,

Salem,

Ibrahim

et al. 2024

European Journal of Gastroenterology &Amp; Hepatology

View full text Add to dashboard Cite

show abstract

“…ETS2 is expressed in a variety of cell types (endothelial cells, macrophages, and stromal fibroblasts) and has been implicated in various diseases, such as atherosclerosis, diabetes mellitus, and the cecal ligation and Although there are many biomarkers for the prognosis of ACLF, the discovery of these molecules has mostly been based on clinical laboratory indicators, which do not reflect the complex backgrounds of diseases. [22][23][24][25] However, the current study was based on a multigroup comparison using transcriptomics, which is more rigorous in terms of methods. Compared to histological biopsy, the use of ETS2 as a noninvasive single biomarker to distinguish the prognosis of ACLF patients is simple and practical.…”

Section: Discussionmentioning

confidence: 99%

“…Although there are many biomarkers for the prognosis of ACLF, the discovery of these molecules has mostly been based on clinical laboratory indicators, which do not reflect the complex backgrounds of diseases 22–25 . However, the current study was based on a multigroup comparison using transcriptomics, which is more rigorous in terms of methods.…”

Section: Discussionmentioning

confidence: 99%

ETS2 alleviates acute‐on‐chronic liver failure by suppressing excessive inflammation

Cai

Liang

et al. 2023

Journal of Medical Virology

View full text Add to dashboard Cite

Hepatitis B virus-related acute-on-chronic liver failure (HBV-ACLF) is a syndrome with high short-term mortality. The mechanism of the transcription factor ETS2 in ACLF remains unclear. This study aimed to clarify the molecular basis of ETS2 in ACLF pathogenesis. Peripheral blood mononuclear cells from patients with HBV-ACLF (n = 50) were subjected to RNA sequencing. Transcriptome analysis showed that ETS2 expression was significantly higher in ACLF patients than in patients with chronic liver diseases and healthy subjects (all p < 0.001). Area-under-ROC analysis of ETS2 demonstrated high values for the prediction of 28-/90-day mortality in ACLF patients (0.908/0.773). Significantly upregulated signatures of the innate immune response (monocytes/neutrophils/inflammation-related pathways) were observed in ACLF patients with high ETS2 expression. Myeloid-specific ETS2 deficiency in liver failure mice resulted in deterioration of biofunctions and increased expression of pro-inflammatory cytokines (IL-6/IL-1β/TNF-α). Knockout of ETS2 in macrophages confirmed the downregulation of IL-6 and IL-1β caused by both HMGB1 and lipopolysaccharide, and an NF-κB inhibitor reversed the suppressive effect of ETS2. ETS2 is a potential prognostic biomarker of ACLF patients that alleviates liver failure by downregulating the HMGB1-/lipopolysaccharide-triggered inflammatory response and may serve as a therapeutic target for ACLF.

show abstract

“…NLR has been reported as being a predictive factor of Tacrolimus overdose in patients who underwent orthotopic heart transplantation [ 31 ]. In liver transplantation receipts, the neutrophil-to-lymphocyte ratio can predict the onset of sepsis [ 32 ]. Patients diagnosed with hepatocellular carcinoma who received orthotopic liver transplantation, and presented with elevated levels of NLR, have a higher risk of postoperative tumor recurrence, being associated with increased mortality [ 33 ].…”

Section: Discussionmentioning

confidence: 99%

Elevated Levels of Neutrophil-to Monocyte Ratio Are Associated with the Initiation of Paroxysmal Documented Atrial Fibrillation in the First Two Months after Heart Transplantation: A Uni-Institutional Retrospective Study

Baba

Suciu

Avram

et al. 2023

JCDD

View full text Add to dashboard Cite

Background: Heart transplantation represents the treatment for patients with end-stage heart failure (HF) being symptomatic despite optimal medical therapy. We investigated the role of NMR (neutrophil-to-monocyte ratio), NLR (neutrophil-to-lymphocyte ratio), NPR (neutrophil-to-platelet ratio), NWR (neutrophil-to-white cells ratio), MLR (monocyte-to-lymphocyte ratio), PLR (platelet-to-lymphocyte ratio), MWR (neutrophil-to-white cells ratio), and LWR (lymphocyte-to-white cells ratio) at the same cut-off values previously studied, to predict complications after heart transplant within 2 months after surgery. Methods: From May 2014 to January 2021, was included 38 patients in our study from the Cardiovascular and Transplant Emergency Institute of Târgu Mureș. Results: Preoperative NMR > 8.9 (OR: 70.71, 95% CI: 3.39–1473.64; p = 0.006) was a risk factor for the apparition of post-operative paroxysmal atrial fibrillation (Afib). In contrast, preoperative MWR > 0.09 (OR: 0.04, 95% CI: 0.003–0.58; p = 0.0182) represented a protective factor against AFib, but being the risk of complications of any cause (OR: 14.74, 95% CI: 1.05–206.59, p = 0.0458). Conclusion: Preoperative elevated levels of NMR were associated with the apparition of documented AFib, with high levels of MWR as a protective factor. High MWR was a risk factor in developing complications of any cause in the first 2 months after heart transplantation.

show abstract

Neutrophil Lymphocyte Ratio can Preempt Development of Sepsis After Adult Living Donor Liver Transplantation

Cited by 4 publications

References 28 publications

Hematological ratios in patients with acute decompensation and acute-on-chronic liver failure: prognostic factors

Hematological ratios in patients with acute decompensation and acute-on-chronic liver failure: prognostic factors

ETS2 alleviates acute‐on‐chronic liver failure by suppressing excessive inflammation

Elevated Levels of Neutrophil-to Monocyte Ratio Are Associated with the Initiation of Paroxysmal Documented Atrial Fibrillation in the First Two Months after Heart Transplantation: A Uni-Institutional Retrospective Study

Contact Info

Product

Resources

About