Abrol Surbhi, Tandon Manish, Raghu Arun M, Pandey Chandrakant
Department of Anesthesia and Critical Care, Northampton General Hospital, Northampton, GBR.
Department of Anesthesiology, Dharamshila Narayana Superspeciality Hospital, Delhi, IND.
Cureus. 2025 Mar 18;17(3):e80749. doi: 10.7759/cureus.80749. eCollection 2025 Mar.
The neutrophil-lymphocyte ratio (NLR) is an easily calculable biomarker known to have a predictive value in cardiac disease, malignancy, and renal failure. However, it has not been studied before in chronic liver disease patients undergoing liver transplantation. We aimed to evaluate the role of the pre-transplantation NLR in predicting the prognosis of patients with chronic liver failure undergoing liver transplantation.
Data was retrospectively collected from 46 patients with chronic liver disease who underwent liver transplantation. The patients were divided into two groups. Group A had 23 patients who survived after liver transplantation. Group B had 23 patients who did not survive. NLR was calculated by dividing the percentage of neutrophils by the percentage of lymphocytes in peripheral blood. The NLR cut-off value was based on a receiver operating characteristic curve analysis. Postoperative complications were also noted.
Preoperative NLR of 3.46 can predict post-transplantation mortality, with the area under the curve (AUC) of 0.86, having a sensitivity of 86.96% and a specificity of 73.91%. NLR emerged as an independent predictor of mortality (hazard ratio (HR) = 4.1, p = 0.028) after adjusting for the Model for End-Stage Liver Disease-Sodium (MELD-Na), creatinine, and neutrophil count. A rising NLR trend was significantly associated with the development of postoperative complications like neurological disease (p < 0.001), coagulopathy (p = 0.004), and acute kidney injury (p = 0.043).
A high preoperative NLR is a predictor of poor outcomes in liver transplantation patients with chronic liver disease.
中性粒细胞与淋巴细胞比值（NLR）是一种易于计算的生物标志物，已知其在心脏病、恶性肿瘤和肾衰竭中具有预测价值。然而，此前尚未在接受肝移植的慢性肝病患者中进行过研究。我们旨在评估移植前NLR在预测接受肝移植的慢性肝衰竭患者预后中的作用。
回顾性收集46例接受肝移植的慢性肝病患者的数据。患者分为两组。A组有23例肝移植后存活的患者。B组有23例未存活的患者。NLR通过外周血中性粒细胞百分比除以淋巴细胞百分比来计算。NLR临界值基于受试者工作特征曲线分析得出。同时记录术后并发症情况。
术前NLR为3.46可预测移植后死亡率，曲线下面积（AUC）为0.86，敏感性为86.96%，特异性为73.91%。在调整终末期肝病-钠模型（MELD-Na）、肌酐和中性粒细胞计数后，NLR成为死亡率的独立预测因子（风险比（HR）=4.1，p=0.028）。NLR上升趋势与术后并发症如神经疾病（p<0.001）、凝血病（p=0.004）和急性肾损伤（p=0.043）的发生显著相关。
术前高NLR是慢性肝病肝移植患者预后不良的预测指标。
