Next Article in Journal
Overdetection of Breast Cancer
Next Article in Special Issue
Outcomes of Geriatric Patients with Hepatocellular Carcinoma
Previous Article in Journal
Patient and Physician Satisfaction with Telemedicine in Cancer Care in Saskatchewan: A Cross-Sectional Study
Previous Article in Special Issue
Effect of COVID-19 Pandemic on Hepatocellular Carcinoma Diagnosis: Results from a Tertiary Care Center in North-West Italy
 
 
Article

Living-Donor Liver Transplantation for Hepatocellular Carcinoma: Impact of the MELD Score and Predictive Value of NLR on Survival

1
Department of Liver and Transplantation Surgery, Chang-Gung Memorial Hospital at Linkou, 5 Fusing St., Gueishan Dist., Taoyuan City 333, Taiwan
2
College of Medicine, Chang-Gung University, Taoyuan City 333, Taiwan
*
Author to whom correspondence should be addressed.
Curr. Oncol. 2022, 29(6), 3881-3893; https://doi.org/10.3390/curroncol29060310
Received: 26 April 2022 / Revised: 18 May 2022 / Accepted: 24 May 2022 / Published: 29 May 2022
Background: Patients with hepatocellular carcinoma (HCC) tend to be referred for liver transplantation (LT) at an early stage of cirrhosis, with lower pre-LT Model of End-Stage Liver Disease (MELD) scores. We investigated the impact of high MELD scores on post-LT outcomes in patients with HCC and validated the prognostic significance of the neutrophil-to-lymphocyte ratio (NLR). Patients and Method: This retrospective single-center cohort study enrolled 230 patients with HCC who underwent LDLT from 2004–2019 in our institute. We defined a high MELD score as ≥20. Results: The MELD < 20 and MELD ≥ 20 groups comprised 205 and 25 cases, respectively. Although there was no significant difference in disease-free survival between the two groups (p = 0.629), the incidence of septic shock (p = 0.019) was significantly higher in the high MELD group. The one-, three-, and five-year overall survival rates were not significantly different between the two groups (p = 0.056). In univariate analysis, a high pre-LT NLR was associated with poorer survival in the high MELD group (p = 0.029, hazard ratio [HR]: 1.07, 90% confidence interval [CI]: 1.02–1.13). NLR cut-off values of ≥10.7 and <10.7 were predictive of mortality, with an AUC of 0.705 (90% CI: 0.532–0.879). The one-, three-, and five-year post-LT survival rates were significantly higher among the recipients with an NLR < 10.7 than those with an NLR ≥ 10.7 (p = 0.005). Conclusions: Pre-LT MELD score ≥ 20 was associated with a higher risk of developing post-LT septic shock and mortality. The pre-LT serum NLR is a useful predictive factor for clinical outcomes in patients with HCC with high MELD scores. View Full-Text
Keywords: liver cancer; liver failure; predictive factors; posttransplant outcomes; living-donor liver transplantation liver cancer; liver failure; predictive factors; posttransplant outcomes; living-donor liver transplantation
Show Figures

Figure 1

MDPI and ACS Style

Hung, H.-C.; Lee, J.-C.; Wang, Y.-C.; Cheng, C.-H.; Wu, T.-H.; Wu, T.-J.; Chou, H.-S.; Chan, K.-M.; Lee, W.-C.; Lee, C.-F. Living-Donor Liver Transplantation for Hepatocellular Carcinoma: Impact of the MELD Score and Predictive Value of NLR on Survival. Curr. Oncol. 2022, 29, 3881-3893. https://doi.org/10.3390/curroncol29060310

AMA Style

Hung H-C, Lee J-C, Wang Y-C, Cheng C-H, Wu T-H, Wu T-J, Chou H-S, Chan K-M, Lee W-C, Lee C-F. Living-Donor Liver Transplantation for Hepatocellular Carcinoma: Impact of the MELD Score and Predictive Value of NLR on Survival. Current Oncology. 2022; 29(6):3881-3893. https://doi.org/10.3390/curroncol29060310

Chicago/Turabian Style

Hung, Hao-Chien, Jin-Chiao Lee, Yu-Chao Wang, Chih-Hsien Cheng, Tsung-Han Wu, Ting-Jung Wu, Hong-Shiue Chou, Kun-Ming Chan, Wei-Chen Lee, and Chen-Fang Lee. 2022. "Living-Donor Liver Transplantation for Hepatocellular Carcinoma: Impact of the MELD Score and Predictive Value of NLR on Survival" Current Oncology 29, no. 6: 3881-3893. https://doi.org/10.3390/curroncol29060310

Find Other Styles

Article Access Map by Country/Region

1
Back to TopTop