Value of the prognostic nutritional index after liver transplantation of hepatocellular carcinoma patients

INTRODUCTION: Hepatocellular carcinoma (HCC) is an important cause of cancer-related deaths in the world. Liver transplantation (LT) is a major treatment option for HCC. Therefore, studies predicting the prognosis of patients after transplantation have special importance.
METHODS: Three hundred and ninety-six patients who underwent LT for HCC between March 2006 and November 2021 were enrolled in this study. The prognostic nutritional index (PNI) was analyzed to evaluate its use in the prognosis of patients after LT. Receiver operating curve (ROC) analysis was performed to detect the cutoff values and then logistic regression and survival analyses were performed to identify independent risk factors of prognosis.
RESULTS: Overall survival (OS) was 9 years (8.2–9.7), disease-free survival (DFS) was 8.7 years (7.9–9.4) and recurrence was 19%. The median PNI value was 35 (15.7–116). Child–Pugh score-A was significant for DFS (P = 0.042) with a cutoff value of 31.02 in ROC analysis. However, no correlation was found between PNI and either OS, DFS, or recurrence.
DISCUSSION AND CONCLUSION: Pre-operative PNI level may not be a good indicator for predicting the survival or recurrence of HCC patients with LT. Further prospective studies are needed to evaluate the importance of PNI levels in patients with LT for HCC.