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Relation between monocyte to high-density lipoprotein cholesterol ratio and prognosis in recipients after liver
Serafettin Okutan1, Hasan Saritas2, Serdar Saritas3
1Division of Surgical Nursing, Nursing Department, Faculty of Health Sciences, Bitlis Eren University, Bitlis, Türkiye.
Insights
High monocyte to HDL-C ratio (MHR) after liver transplantation indicates a higher risk of mortality. Monitoring MHR in liver transplant recipients can help identify those needing closer observation for improved outcomes.
Area of Science:
- Hepatology
- Transplantation Immunology
- Biomarkers
Background:
- End-stage liver disease necessitates liver transplantation.
- Monocytes/macrophages and high-density lipoprotein cholesterol (HDLC) influence hepatic inflammation and oxidative stress.
- The impact of the monocyte to HDL-C ratio (MHR) on post-transplant outcomes requires further investigation.
Purpose of the Study:
- To investigate the association between MHR and clinical progression and outcomes in liver transplant recipients.
- To determine if MHR can predict post-transplant survival.
Main Methods:
- Retrospective analysis of 464 liver transplant recipients.
- Extraction of patient data including MHR and other blood parameters.
- Statistical analysis using Pearson correlation and ROC curve analysis to assess MHR's relationship with graft dysfunction and survival.
Main Results:
- MHR levels were significantly higher in patients who died post-transplantation compared to survivors (p < 0.01).
- MHR correlated with increased MELD score and hospitalization duration.
- MHR was not significantly affected by gender or age but was higher in patients with chronic diseases.
Conclusions:
- Increased MHR post-liver transplantation is correlated with an elevated risk of mortality.
- MHR serves as a potential predictive biomarker for liver transplant outcomes.
- Close perioperative monitoring of liver transplant recipients with high MHR is recommended.
Background:
The end-stage liver diseases require liver transplantation as the life-saving solution. It is known that monocytes/macrophages and high-density lipoprotein cholesterol (HDLC) have important contributions to the development of hepatic inflammation and oxidative stress before liver transplantation. However, the effect of monocyte/HDL-C ratio (MHR) on clinical progression and outcome in the post-transplant period are not fully understood. Our hypothesis is that the MHR value may be associated with poor vs. good outcomes after liver transplantation.
Methods:
In our retrospective study, we included 464 liver transplant recipients. Patients' data were extracted from electronic and other paper records in our teaching/research hospital. The MHR values and other blood parameters (creatinine, total protein, albumin, etc.) were expressed as a mean and standard deviation, which were analyzed by the Pearson correlation test. The relationship between graft dysfunction and MHR was determined by ROC curve analysis.
Results:
The mean age of liver transplant recipients was 45.8 ± 13.7 years. Nineteen percent of patients had liver failure due to Alcoholic Fatty Liver Disease (AFLD) and 34.5 % had liver failure due to hepatitis B virus. At the end of 3 months after liver transplantation, 84.5 % of liver transplant recipients were alive, 5.8 % experienced graft rejection and 5.17 % had an infection. There was a statistically significant improvement in total protein, albumin, liver function tests, and serum creatinine values of the survivors (all p < 0.05). The MHR levels were significantly higher in patients who died after transplantation in comparison to those who survived before and after liver transplantation and these differences were statistically significant (p < 0.01).
Conclusion:
The increased MHR values of recipients after liver transplantation correlated with their risk of survival. Furthermore, the MHR value increased with increased MELD score and the number of days of hospitalization and was not affected by gender and age. MHR was higher in patients with chronic diseases. Patients with high MHR before and after transplantation should be monitored more closely in the perioperative period.
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