![]() ![]() Since the introduction of Milan’s criteria, the long-term survival rates after liver transplantation (LT) for patients with hepatocellular carcinoma (HCC) have improved significantly. The pre-LT serum NLR is a useful predictive factor for clinical outcomes in patients with HCC with high MELD scores. Conclusions: Pre-LT MELD score ≥ 20 was associated with a higher risk of developing post-LT septic shock and mortality. 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). In univariate analysis, a high pre-LT NLR was associated with poorer survival in the high MELD group ( p = 0.029, hazard ratio : 1.07, 90% confidence interval : 1.02–1.13). The one-, three-, and five-year overall survival rates were not significantly different between the two groups ( p = 0.056). 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. Results: The MELD < 20 and MELD ≥ 20 groups comprised 205 and 25 cases, respectively. Patients and Method: This retrospective single-center cohort study enrolled 230 patients with HCC who underwent LDLT from 2004–2019 in our institute. 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). 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.
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