Yamamoto Haruchika, Sugimoto Seiichiro, Soh Junichi, Shiotani Toshio, Miyoshi Kentaroh, Otani Shinji, Okazaki Mikio, Yamane Masaomi, Toyooka Shinichi
Department of General Thoracic Surgery and Organ Transplant Center, Okayama University Hospital, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan.
Surg Today. 2021 Oct;51(10):1610-1618. doi: 10.1007/s00595-021-02244-2. Epub 2021 Feb 13.
The prognostic nutritional index (PNI), calculated based on the serum albumin levels and the total lymphocyte count, has been identified as a predictor of clinical outcomes in various fields of surgery. In this study, we investigated the relationship between the PNI and the lung allocation score (LAS) as well as the impact of the PNI on the outcomes of both cadaveric lung transplantation (CLT) and living-donor lobar lung transplantation (LDLLT).
We reviewed retrospective data for 127 recipients of lung transplantation (LT), including 71 recipients of CLT and 56 recipients of LDLLT.
The PNI was correlated significantly and negatively with the LAS (r = - 0.40, P = 0.0000037). Multivariate analysis revealed that age (P = 0.00093), BMI (P = 0.00087), and PNI (P = 0.0046) were independent prognostic factors of a worse outcome after LT. In a subgroup analysis, survival after both CLT (P = 0.015) and LDLLT (P = 0.041) was significantly worse in the low PNI group than in the high PNI group.
Preoperative nutritional evaluations using the PNI can assist with the assessment of disease severity in LT recipients and may predict survival after both CLT and LDLLT.
基于血清白蛋白水平和总淋巴细胞计数计算得出的预后营养指数（PNI）已被确定为各个外科领域临床结局的预测指标。在本研究中，我们调查了PNI与肺分配评分（LAS）之间的关系，以及PNI对尸体肺移植（CLT）和活体供肺叶移植（LDLLT）结局的影响。
我们回顾了127例肺移植受者的回顾性数据，其中包括71例CLT受者和56例LDLLT受者。
PNI与LAS呈显著负相关（r = -0.40，P = 0.0000037）。多变量分析显示，年龄（P = 0.00093）、BMI（P = 0.00087）和PNI（P = 0.0046）是LT后预后较差的独立预测因素。在亚组分析中，低PNI组CLT（P = 0.015）和LDLLT（P = 0.041）后的生存率均显著低于高PNI组。
使用PNI进行术前营养评估有助于评估LT受者的疾病严重程度，并可能预测CLT和LDLLT后的生存率。
