Lee Boram, Choi YoungRok, Cho Jai Young, Yoon Yoo-Seok, Han Ho-Seong
Department of Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea.
Department of Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.
Ann Surg Treat Res. 2020 Dec;99(6):337-343. doi: 10.4174/astr.2020.99.6.337. Epub 2020 Nov 26.
The aim of this study was to evaluate the predictive value of neutrophil-to-lymphocyte ratio (NLR) in acute cellular rejection (ACR) after living donor liver transplantation (LDLT).
All consecutive patients who underwent ABO-compatible (ABOc) LDLT from September 2014 to December 2017 were retrospectively reviewed. NLR was calculated on 3 occasions; (1) 4 weeks prior to liver transplantation (LT), (2) the day of LT, and (3) the day before liver biopsy.
Among 66 patients who underwent ABOc LDLT, ACR was identified in 15 patients (22.7%) on protocol liver biopsy performed routinely on the postoperative day 7. There was no significant difference in NLR at 4 weeks prior to LT and the day of LT between no-ACR and ACR group (2.98 ± 1.92 2.54 ± 1.15, P = 0.433; 17.9 ± 8.31 20.5 ± 13.4, P = 0.393). However, NLR was significantly lower in ACR group compared to non-ACR group just prior to liver biopsy (5.82 ± 3.42 18.4 ± 17.2, P = 0.035). NLR tends to decrease 3.5 days before the onset of ACR. The area under the receiver operating characteristic curve for optimal cut-off value of NLR was 6.49, with sensitivity and specificity of 80.4% and 73.3% respectively.
NLR has a potential as a noninvasive predictor of early ACR in ABOc LDLT.
本研究旨在评估中性粒细胞与淋巴细胞比值(NLR)在活体肝移植(LDLT)后急性细胞排斥反应(ACR)中的预测价值。
回顾性分析2014年9月至2017年12月期间连续接受ABO血型相容(ABOc)LDLT的所有患者。在三个时间点计算NLR:(1)肝移植(LT)前4周;(2)LT当天;(3)肝活检前一天。
在66例接受ABOc LDLT的患者中,术后第7天常规进行的方案肝活检发现15例(22.7%)发生ACR。无ACR组和ACR组在LT前4周和LT当天的NLR无显著差异(2.98±1.92对2.54±1.15,P = 0.433;17.9±8.31对20.5±13.4,P = 0.393)。然而,在肝活检前,ACR组的NLR显著低于非ACR组(5.82±3.42对18.4±17.2,P = 0.035)。NLR在ACR发作前3.5天趋于下降。NLR最佳截断值的受试者工作特征曲线下面积为6.49,敏感性和特异性分别为80.4%和73.3%。
NLR有可能作为ABOc LDLT中早期ACR的无创预测指标。