Clinical value and limitations of the preoperative C-reactive-protein-to-albumin ratio in predicting post-operative morbidity and mortality after deceased-donor liver transplantation: a retrospective single-centre study

I. Amygdalos, J. Bednarsch, F.A. Meister, D. Erren, A. Mantas, P. Strnad, S.A. Lang, T.F. Ulmer, J. Boecker, W.J. Liu, D.C. Jiang, P. Bruners, U.P. Neumann, Z. Czigany*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

4 Citations (Web of Science)

Abstract

Liver transplantation is still associated with a high risk of severe complications and post-operative mortality. This study examines the predictive value of the preoperative C-reactive-protein-to-albumin ratio (CAR) regarding perioperative morbidity and mortality in deceased-donor liver transplantation (DDLT) recipients. In total, 390 DDLT recipients between 05/2010 and 03/2020 were eligible. Predictive abilities of CAR were examined through receiver operating characteristic curve (ROC) analyses. Groups were compared using parametric and non-parametric tests as appropriate. Independent risk factors for morbidity and mortality were identified using uni- and multivariable logistic regression analyses. A good predictive ability for CAR was shown regarding perioperative morbidity (comprehensive complication index >= 75, Clavien-Dindo score >= 4a) and 12-month mortality, with an ideal cut-off of CAR = 26%. Patients with CAR>26% had significantly higher median CCI scores (60 vs. 43, P < 0.001), longer intensive care unit (ICU, 5 vs. 4 days, P < 0.001) and hospital (28 vs. 21 days, P < 0.001) stays and higher 12-month mortality rates (20% vs 6%, P < 0.001). Multivariable analyses identified CAR>26%, pre-OLT inpatient hospitalization (including ICU) and post-operative red blood cell transfusions as independent predictors of severe cumulative morbidity (CCI >= 75). Preoperative CAR might be a reliable additional tool to predict perioperative morbidity and mortality in DDLT recipients.
Original languageEnglish
Pages (from-to)1468-1480
Number of pages13
JournalTransplant International
Volume34
Issue number8
DOIs
Publication statusPublished - 1 Aug 2021

Keywords

  • albumin
  • CRP
  • graft loss
  • morbidity
  • orthotopic liver transplantation
  • outcome
  • EARLY ALLOGRAFT DYSFUNCTION
  • PROTEIN/ALBUMIN RATIO
  • MODEL
  • SURVIVAL
  • SCORE
  • OUTCOMES
  • INFLAMMATION
  • ALLOCATION
  • CANCER

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