Li C, Chen HX, Lai YH. Comparison of different preoperative objective nutritional indices for evaluating 30-d mortality and complications after liver transplantation. World J Gastrointest Surg 2024; 16(1): 143-154 [PMID: 38328316 DOI: 10.4240/wjgs.v16.i1.143]
Corresponding Author of This Article
Yan-Hua Lai, Doctor, Chief Physician, Director, Professor, Department of Transplantation, People’s Hospital of Guangxi Zhuang Autonomous Region, No. 6 Taoyuan Road, Nanning 530021, Guangxi Zhuang Autonomous Region, China. 1379771812@qq.com
Research Domain of This Article
Transplantation
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Surg. Jan 27, 2024; 16(1): 143-154 Published online Jan 27, 2024. doi: 10.4240/wjgs.v16.i1.143
Comparison of different preoperative objective nutritional indices for evaluating 30-d mortality and complications after liver transplantation
Chuan Li, Hong-Xia Chen, Yan-Hua Lai
Chuan Li, Yan-Hua Lai, Department of Transplantation, People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning 530021, Guangxi Zhuang Autonomous Region, China
Hong-Xia Chen, Department of Clinical Pharmacy, People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning 530021, Guangxi Zhuang Autonomous Region, China
Author contributions: Li C conceived the study, collected and analyzed the data and drafted the manuscript; Chen HC assisted with the data collection; Lai YH revised the manuscript; and all the authors read and approved the final version to be published.
Supported byThe Self-Funded Research Project of the Health Commission of Guangxi Zhuang Autonomous Region, No. Z-A20230045.
Institutional review board statement: The study was reviewed and approved by the Ethics Committee of Guangxi Zhuang Autonomous Region People's Hospital, No. KY-ZC-2023-056.
Informed consent statement: All patients provided written informed consent for data analysis before transplantation.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yan-Hua Lai, Doctor, Chief Physician, Director, Professor, Department of Transplantation, People’s Hospital of Guangxi Zhuang Autonomous Region, No. 6 Taoyuan Road, Nanning 530021, Guangxi Zhuang Autonomous Region, China. 1379771812@qq.com
Received: October 29, 2023 Peer-review started: October 29, 2023 First decision: December 6, 2023 Revised: December 17, 2023 Accepted: January 8, 2024 Article in press: January 8, 2024 Published online: January 27, 2024 Processing time: 87 Days and 24 Hours
Abstract
BACKGROUND
The nutritional status is closely related to the prognosis of liver transplant recipients, but few studies have reported the role of preoperative objective nutritional indices in predicting liver transplant outcomes.
AIM
To compare the predictive value of various preoperative objective nutritional indicators for determining 30-d mortality and complications following liver transplantation (LT).
METHODS
A retrospective analysis was conducted on 162 recipients who underwent LT at our institution from December 2019 to June 2022.
RESULTS
This study identified several independent risk factors associated with 30-d mortality, including blood loss, the prognostic nutritional index (PNI), the nutritional risk index (NRI), and the control nutritional status. The 30-d mortality rate was 8.6%. Blood loss, the NRI, and the PNI were found to be independent risk factors for the occurrence of severe postoperative complications. The NRI achieved the highest prediction values for 30-d mortality [area under the curve (AUC) = 0.861, P < 0.001] and severe complications (AUC = 0.643, P = 0.011). Compared to those in the high NRI group, the low patients in the NRI group had lower preoperative body mass index and prealbumin and albumin levels, as well as higher alanine aminotransferase and total bilirubin levels, Model for End-stage Liver Disease scores and prothrombin time (P < 0.05). Furthermore, the group with a low NRI exhibited significantly greater incidences of intraabdominal bleeding, primary graft nonfunction, and mortality.
CONCLUSION
The NRI has good predictive value for 30-d mortality and severe complications following LT. The NRI could be an effective tool for transplant surgeons to evaluate perioperative nutritional risk and develop relevant nutritional therapy.
Core Tip: The preoperative nutritional status of liver transplant patients is closely related to prognosis. In this study, we analyzed clinical data from 162 patients to compare the value of different objective nutritional indices in predicting 30-d mortality and complications following liver transplantation. This provides insights for the preoperative assessment of liver transplant prognosis.
