The effect of Lymphocyte Monocyte Ratio (LMR) on 30-day mortality of non-HCC post-transplant liver patients admitted to the intensive care unit

Year 2025, Volume: 52 Issue: 1, 1 - 6, 14.03.2025

Vecihe Bayrak , Mehmet Çağatay Gürkök , Cihan Ağalar , Tarkan Unek , Ferhan Demirer Aydemir , İrem Erdoğan Veziroğlu , Necati Gökmen

https://doi.org/10.5798/dicletip.1657071

Abstract

Aim: Our study aims to investigate the effect of the LMR value on the 30-day mortality and intensive care hospitalization days of post-transplant liver patients without hepatocellular cancer(HCC) admitted to the intensive care unit(ICU).
Methods: Our retrospective study included post-liver transplant patients in the ICU of Dokuz Eylul University Hospital between 2010 and 2020. We recorded patients' age, gender, aetiology of liver disease, donor type (living or deceased), duration of cold ischemia, scores, hospitalization days in the ICU, and 30-day mortality. LMR was calculated by dividing the patient's lymphocyte count by the monocyte count. Statistical analyses were performed using SPSS software version 24.0.
Results: 128 (92 male, 36 female) patients were included in our study. Twenty-four patients died within 30 days. The mean LMR was 1.498±2.134, and no significant difference existed between those with and without 30-day mortality (p=0.995). LMR value was not a predictor of mortality and ICU hospitalization days in these patients.
Conclusion: Our study revealed that LMR does not predict mortality or hospitalization days in post-liver transplant patients without HCC. The results of our study and previous studies suggest that LMR alteration is associated with an immune state produced by the tumour microenvironment. Our findings suggest that LMR may not be a valuable biomarker for predicting patient outcomes in post-liver transplant patients without HCC. However, this study provides a starting point for further investigation into the role of LMR in cancer diseases.

Keywords

Critical Care Medicine, Hematological changes, Liver failure, Viral hepatitis

References

• 1.Qi X, Wang C, Shan X. Peripheral Blood Cell Ratiosas Prognostic Predictors of Mortality in Patientswith Hepatitis B Virus-Related DecompensatedCirrhosis. Clin Lab. 2021 Dec 1;67(12).
• 2.Dai K, Li Z, Luo Y, et all. The Predictive Value of theMonocyte-to-Lymphocyte Ratio and Monocyte-to-Haematocrit Ratio for Cardiac Rupture Patients withAcute Myocardial Infarction: A Propensity ScoreMatching Analysis. Risk Manag Health Policy. 2022Jan 16;15:37-44.
• 3.Urbanowicz T, Olasińska-Wiśniewska A, MichalakM, et all. The Prognostic Significance of Neutrophilto Lymphocyte Ratio (NLR), Monocyte toLymphocyte Ratio (MLR) and Platelet toLymphocyte Ratio (PLR) on Long-Term Survival inOff-Pump Coronary Artery Bypass Grafting (OPCAB)Procedures. Biology (Basel). 2021 Dec 27;11(1):34.
• 4.Nouri-Vaskeh M, Mirza-Aghazadeh-Attari M,Pashazadeh F, et all. Prognostic Impact of Monocyteto Lymphocyte Ratio in Clinical Outcome of Patientswith Hepatocellular Carcinoma: A SystematicReview and Meta-analysis. Galen Med J. 2020 Dec25;9: e1948.
• 5.Song W, Tian C, Wang K et all. The pretreatmentlymphocyte to monocyte ratio predicts clinicaloutcome for patients with hepatocellular carcinoma: A meta-analysis. Sci Rep. 2017 Apr 18;7:46601.
• 6.Li Y, Liu Y, Zhou C, et al. l. [Monocyte/lymphocyteratio as a predictor of 30-day mortality and adverseevents in critically ill patients: analysis of the MIMIC-III database]. Zhonghua Wei Zhong Bing Ji Jiu Yi Xue.2021 May;33(5):582-6. Chinese.
• 7.Kalın BS, Özçaylak S, Solmaz İ, et all. Assessmentof Risk Factors for Mortality in Patients in MedicalIntensive Care Unit of a Tertiary Hospital. Indian JCrit Care Med. 2022 Jan;26(1):49-52.
• 8.Sato S, Shimizu T, Ishizuka M, et all. Thepreoperative pan-immune-inflammation value is anovel prognostic predictor for stage I-III colorectalcancer patients undergoing surgery. Surg Today.2022 Jan 11.
• 9.Gao P, Peng W, Hu Y. Prognostic andclinicopathological significance of lymphocyte-to-monocyte ratio in patients with nasopharyngealcarcinoma. Head Neck. 2022 Mar;44(3):624-32.
• 10.Takamizawa S, Shimoi T, Satomi-Tsushita N, etall. Neutrophil-to-lymphocyte ratio as a prognosticfactor for patients with metastatic or recurrentbreast cancer treated using capecitabine: aretrospective study. BMC Cancer. 2022 Jan14;22(1):64.
• 11.Li W, Tao L, Zhang L, Xiu D. Prognostic role oflymphocyte to monocyte ratio for patients withpancreatic cancer: a systematic review and meta-analysis. Onco Targets Ther. 2017 Jul 11;10:3391-7.
• 12.Kurihara T, Harada N, Morinaga A, et all.Predictive Factors for the Resectable Type ofHepatocellular Carcinoma Recurrence After LivingDonor Liver Transplant. Transplant Proc. 2023 Jan-Feb;55(1):191-6.
• 13.Mano Y, Yoshizumi T, Yugawa K, et al. l.Lymphocyte-to-Monocyte Ratio Is a Predictor ofSurvival After Liver Transplantation forHepatocellular Carcinoma. Liver Transpl. 2018Nov;24(11):1603-11.