21 July 2015 : Original article
Prediction of Intraoperative Circulatory Risk Based on Preoperative Neutrophil-to-Lymphocyte Ratio in Patients Undergoing Living Donor Liver Transplantation
Hyun Sik ChungBDE, Eun Sung KimCF, Min Ji ChoB, Chul Soo ParkACDEFDOI: 10.12659/AOT.894048
Ann Transplant 2015; 20:408-417
Abstract
BACKGROUND: Intraoperative circulatory risk factors are associated with unfavorable outcomes after living donor liver transplantation (LDLT). We investigated whether the preoperative neutrophil-to-lymphocyte ratio (NLR) can predict intraoperative circulatory risks.
MATERIAL AND METHODS: The perioperative data of 276 patients who underwent LDLT were reviewed retrospectively. The intraoperative circulatory risk score (ICRS) was calculated using the inotropic score, hypotension, blood transfusion, oliguria, and change in serum lactate during LDLT. Perioperative variables including NLRs were compared between the high (≥3.0) and low (<3.0) ICRS groups, and a predictive model for high ICRS was developed.
RESULTS: A high ICRS was associated with poor preoperative physical condition and unfavorable postoperative outcomes. The NLR progressively increased during the LDLT perioperative period. However, only preoperative NLRs differed significantly between the high and low ICRS groups (6.2 vs. 3.9, respectively; p<0.05). The predictive accuracy of the NLR (area under the receiver operator curve, 0.635) did not differ from those of the model for end-stage liver disease (MELD) and Child-Pugh-Turcotte scores. After multivariate adjustment, preoperative NLR ≥3.8 was identified as an independent predictor of high ICRS (risk ratio 3.15; p=0.004) together with preoperative hemodialysis and intraoperatively administered calcium chloride.
CONCLUSIONS: Intraoperative circulatory risks are associated with several detrimental outcomes following LDLT. The preoperative NLR is predictive of intraoperative circulatory risks.
Keywords: Cerebrovascular Circulation, Decision Support Techniques, Intraoperative Period, Leukocyte Count, Liver Transplantation
617 9
In Press
02 Jun 2023 : Original article
Survival analysis of transplant-associated thrombotic microangiopathy under different diagnostic criteria a...Ann Transplant In Press; DOI: 10.12659/AOT.939890
17 May 2023 : Original article
Results of Liver Retransplantation After Rescue Hepatectomy: A Single-Center StudyAnn Transplant In Press; DOI: 10.12659/AOT.939557
10 May 2023 : Original article
Incidence of Thromboembolic Complications Following Kidney Transplantation with Short and Extended Aspirin ...Ann Transplant In Press; DOI: 10.12659/AOT.939143
Most Viewed Current Articles
24 Aug 2021 : Review article
Normothermic Machine Perfusion (NMP) of the Liver – Current Status and Future PerspectivesDOI :10.12659/AOT.931664
Ann Transplant 2021; 26:e931664
26 Jan 2022 : Review article
Recurrence of Hepatocellular Carcinoma After Liver Transplantation: Risk Factors and Predictive ModelsDOI :10.12659/AOT.934924
Ann Transplant 2022; 27:e934924
29 Dec 2021 : Original article
Efficacy and Safety of Tacrolimus-Based Maintenance Regimens in De Novo Kidney Transplant Recipients: A Sys...DOI :10.12659/AOT.933588
Ann Transplant 2021; 26:e933588
15 Mar 2022 : Case report
Combined Liver, Pancreas-Duodenum, and Kidney Transplantation for Patients with Hepatitis B Cirrhosis, Urem...DOI :10.12659/AOT.935860
Ann Transplant 2022; 27:e935860