Department of Anesthesiology and Pain Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Department of Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
PLoS One. 2019 Dec 10;14(12):e0226369. doi: 10.1371/journal.pone.0226369. eCollection 2019.
This study was performed to determine the association between the ratio of C-reactive protein to albumin (CRP/ALB) and the risk of early allograft dysfunction (EAD) in patients undergoing living donor liver transplantation (LDLT).
A total of 588 adult patients undergoing LDLT were retrospectively investigated, after 22 were excluded because of signs of overt infection or history of ALB infusion. The study population was classified into high and low CRP/ALB ratio groups according to EAD. All laboratory variables, including CRP and ALB, had been collected on the day before surgery. A percentage value for the CRP/ALB ratio (%) was calculated as CRP/ALB × 100.
After LDLT, 83 patients (14.1%) suffered EAD occurrence. A higher CRP/ALB ratio was independently associated with risk of EAD, Model for End-stage Liver Disease score, fresh frozen plasma transfusion, and donor age. Based on a cutoff CRP/ALB ratio (i.e., > 20%), the probability of EAD was significantly (2-fold) higher in the high versus low CRP/ALB group. The predictive utility of CRP/ALB ratio for EAD was greater than those of other inflammatory markers. In addition, patients with a high CRP/ALB ratio had poorer survival than those with a low CRP/ALB ratio during the follow-up period.
The easily calculated CRP/ALB ratio may allow estimation of the risk of EAD after LDLT and can provide additional information that may facilitate the estimation of a patient's overall condition.
本研究旨在确定 C 反应蛋白与白蛋白比值（CRP/ALB）与活体肝移植（LDLT）患者早期移植物功能障碍（EAD）风险之间的关系。
回顾性调查了 588 例接受 LDLT 的成年患者，排除了 22 例因明显感染迹象或 ALB 输注史的患者。根据 EAD，将研究人群分为 CRP/ALB 比值高和低的两组。所有实验室变量，包括 CRP 和 ALB，均在手术前一天采集。CRP/ALB 比值的百分比值计算为 CRP/ALB×100。
LDLT 后，83 例（14.1%）患者发生 EAD。较高的 CRP/ALB 比值与 EAD、终末期肝病模型评分、新鲜冷冻血浆输注和供体年龄的风险独立相关。基于 CRP/ALB 比值的截止值（即>20%），与 CRP/ALB 比值低的患者相比，CRP/ALB 比值高的患者发生 EAD 的可能性显著增加（2 倍）。CRP/ALB 比值对 EAD 的预测效能大于其他炎症标志物。此外，在随访期间，CRP/ALB 比值高的患者的生存率低于 CRP/ALB 比值低的患者。
易于计算的 CRP/ALB 比值可以估计 LDLT 后 EAD 的风险，并提供额外的信息，有助于估计患者的整体状况。
