Preoperative Neutrophil-to-Lymphocyte Ratio as an Independent Predictor of 1-Year Graft Loss and Mortality After Orthotopic Liver Transplantation

Nylec, Marcin; Derbisz, Kamil; Chrząszcz, Patrycja; Wrońska, W.; Król, Robert; Wystrychowski, Wojciech

doi:10.1016/j.transproceed.2020.03.036

Cited by 4 publications

(5 citation statements)

References 16 publications

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“…They hold the view that maintaining high serum albumin level reflects good nutritional status and can reduce the amount of fluid collection in abdominal or thoracic cavity, which could resist the catabolic state induced by surgical stress and inflammatory response in the early postoperative period. As for PLR, our findings stay consistent with several observations of the PLR prognostic role in patients undergoing LT [ 46 , 47 ]. Pravisani et al [ 47 ] reported that pre-LT and post-LT PLR has shown clear associations with short- or long-term outcomes and HCC recurrence, which can be used as inflammatory and nutritional biomarkers to offer reliable prognostic information after LT. Elevated PLR reflects the more severer liver inflammation and worse nutritional status, and this may be the reason why PLR was significantly associated with EAD [ 48 ].…”

Section: Discussionsupporting

confidence: 92%

“…The clinical and body composition characteristics of patients in the two groups are summarized in Table 1. Median recipient age at transplant was 49 (42)(43)(44)(45)(46)(47)(48)(49)(50)(51)(52)(53)(54) [IQR] years, and 81.1% (n = 142) of patients were male. No significant differences in age and gender were found between the two groups (p = 0.435; p = 0.069, respectively).…”

Section: Patient Characteristicsmentioning

confidence: 99%

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High visceral adipose tissue area is independently associated with early allograft dysfunction in liver transplantation recipients: a propensity score analysis

Yuan

Liang

et al. 2022

Insights Imaging

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Objectives To evaluate the association between adipose tissue distribution and early allograft dysfunction (EAD) in liver transplantation (LT) recipients. Methods A total of 175 patients who received LT from April 2015 to September 2020 were enrolled in this retrospective study. The areas of abdominal adipose tissue and skeletal muscle of all patients were measured based on the preoperative CT images. The appropriate statistical methods including the propensity score-matched (PSM) analysis were performed to identify the association between adipose tissue distribution and EAD. Results Of 175 LT recipients, 55 patients (31.4%) finally developed EAD. The multivariate logistic analysis revealed that preoperative serum albumin (odds ratio (OR) 0.34, 95% confidence interval (CI) 0.17–0.70), platelet–lymphocyte ratio (OR 2.35, 95% CI 1.18–4.79), and visceral adipose tissue (VAT) area (OR 3.17, 95% CI 1.56–6.43) were independent associated with EAD. After PSM analysis, VAT area was still significantly associated with EAD (OR 3.95, 95% CI 1.16–13.51). In survival analysis, no significant difference was identified in one-year graft failure (log-rank: p = 0.487), and conversely result was identified in overall survival (OS) (log-rank: p = 0.012; hazard ratio (HR) 4.10, 95% CI 1.27–13.16). Conclusions LT recipients with high VAT area have higher risk for the occurrence of EAD, and high VAT area might have certain clinical value for predicting the poor OS of patients. For LT candidates with large amount of VAT, the clinicians can take clinical interventions by suggesting physical and nutritional treatments to improve outcomes after LT.

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Section: Discussionsupporting

confidence: 92%

Section: Patient Characteristicsmentioning

confidence: 99%

High visceral adipose tissue area is independently associated with early allograft dysfunction in liver transplantation recipients: a propensity score analysis

Yuan

Liang

et al. 2022

Insights Imaging

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“…For several years, NLR has been known as an indicator of systemic inflammatory status, reflecting the balance between innate and adaptive immune function. The association between preoperative NLR and EAD was already known and described in adult liver transplantation after both cadaveric and living donation (Kwon et al 2019 ; Nylec et al 2020 ). It is explained by the crucial role of the inflammatory response and the preoperative immune status of the recipient in the development of EAD (Oweira et al 2016 ).…”

Section: Discussionmentioning

confidence: 82%

Sevoflurane preconditioning in living liver donation is associated with better initial graft function after pediatric transplantation: a retrospective study

Dieu,

Benoit,

Dupont

et al. 2024

Perioper Med

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Introduction Initial allograft function determines the patient’s immediate prognosis in pediatric liver transplantation. Ischemia-reperfusion injuries play a role in initial poor graft function (IPGF). In animal studies, preconditioning with inhaled anesthetic agents has demonstrated a protective effect on the liver. In humans, the few available studies are conflicting. This study assesses the association between the hypnotic agent used to maintain anesthesia during hepatectomy in living donors and the occurrence of IPGF after pediatric transplantation. Methods We conducted a single-center retrospective analysis of children who received a living donor liver transplant (LDLT) between 2010 and 2019. We analyzed the incidence of EAD according to the hypnotic agent used to maintain general anesthesia during donor hepatectomy. Results We included 183 pairs of patients (living donors-recipients). The anesthetics used in the donor were propofol (n = 85), sevoflurane (n = 69), or propofol with sevoflurane started 30 min before clamping (n = 29). Forty-two children (23%) developed IPGF. After multivariate logistic regression analysis, factors significantly associated with the occurrence of IPGF were the anesthesia maintenance agent used in the donor (p = 0.004), age of the donor (p = 0.03), duration of transplant surgery (p = 0.009), preoperative receiver neutrophil to lymphocyte ratio (p = 0.02), and albumin (p = 0.05). Conclusion Significantly fewer children who received a graft from a donor in whom only sevoflurane was used to maintain anesthesia developed IPGF. Although additional research is needed, this preconditioning strategy may provide an option to prevent IPGF after living liver donation.

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“…RDW and other perioperative inflammatory biomarkers (such as neutrophil-to-lymphocyte ratio, lymphocyte-to-monocyte ratio, platelet-to-lymphocyte ratio, and systemic immune-inflammation index) are common test parameters that are easily accessible and relatively inexpensive for clinicians. In recent years, there have been many studies exploring the association between these perioperative inflammatory biomarkers and the prognosis of LTRs, but the results are not consistent [19][20][21][22][23][24][25]. This may be because these markers only reflect part of the patient's inflammatory status, and the predictive value of a single biomarker is limited.…”

Section: Discussionmentioning

confidence: 99%

Association of Preoperative Red Cell Distribution Width with Postoperative Outcomes in Liver Transplantation Recipients

Wang

2024

Asp Biomed Clin Case Rep

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Background: The 1-year mortality rate after liver transplantation is approximately 8%-20%. It is important to explore risk factors associated with postoperative outcomes in liver transplantation recipients (LTRs). Red cell distribution width (RDW) is an indicator that assesses the variability in the volume of red blood cells in circulation. RDW is not only related to inflammatory levels and nutritional status but also associated with postoperative outcomes in surgical patients. However, the relationship between preoperative RDW and postoperative outcomes in LTRs remains unclear. Therefore, we designed a retrospective observational study to investigate the impact of preoperative RDW levels on postoperative outcomes in LTRs. Methods: We retrospectively collected clinical data of patients who underwent allogeneic liver transplantation at West China Hospital, Sichuan University, from January 2016 to December 2020. The primary outcome was 1-year mortality. Secondary outcomes included 30-day mortality, long-term survival, early postoperative graft dysfunction, acute kidney injury, renal replacement therapy, pulmonary complications, duration of postoperative mechanical ventilation, length of ICU stay, and length of hospital stay. Patients were divided into two groups: RDW ≤ 14.5% and RDW > 14.5%. We selected 14 covariates and used propensity score matching (PSM) to adjust for baseline characteristics. Postoperative outcomes and long-term survival were analyzed after PSM. Receiver operating characteristics (ROC) curves and subgroup analyses were also performed. Results: A total of 661 patients who underwent liver transplantation surgery were screened for this study. Finally, 438 patients were included in the statistical analysis. After PSM, there were no statistically significant differences in postoperative mortality and complications between the RDW ≤ 14.5% group and the RDW > 14.5% group (P > 0.05). The comparison of long-term survival between the two groups also showed no statistical difference (hazard ratio = 0.67, 95% confidence interval: 0.28-1.61, P = 0.358). Subgroup analyses showed consistent results. The ROC curve indicated that the predictive ability of preoperative RDW levels for 1-year mortality is moderate (area under the ROC curve 0.661). Conclusion: Preoperative RDW levels do not affect postoperative mortality and the incidence of complications in LTRs. However, these results still need further research for verification.

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Preoperative Neutrophil-to-Lymphocyte Ratio as an Independent Predictor of 1-Year Graft Loss and Mortality After Orthotopic Liver Transplantation

Cited by 4 publications

References 16 publications

High visceral adipose tissue area is independently associated with early allograft dysfunction in liver transplantation recipients: a propensity score analysis

High visceral adipose tissue area is independently associated with early allograft dysfunction in liver transplantation recipients: a propensity score analysis

Sevoflurane preconditioning in living liver donation is associated with better initial graft function after pediatric transplantation: a retrospective study

Association of Preoperative Red Cell Distribution Width with Postoperative Outcomes in Liver Transplantation Recipients

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