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. 2019 Jan 27;11(1):50–64. doi: 10.4254/wjh.v11.i1.50

Table 3.

Main studies analyzing several pre-liver transplantation systemic inflammation biomarkers and proposed scores

Reference Country LT type n Biomarkers Time of biomarker test Risk factors by multivariate analysis Risk score
Yoshizumi et al[95], 2013 Japan LDLT 104 AFP > 400, DCP > 300, NLR ≥ 4 Not specified NLR, tumor size + number ≥ 8 No
Na et al[96], 2014 Korea LDLT 224 AFP ≥ 100, NLR ≥ 6, CRP ≥ 1, Day of LT NLR ≥ 6 and AFP ≥ 100 Prognostic factor score: NLR ≥ 6 and CRP ≥ 1 (one point each)
Shindoh et al[80], 2014 Japan LDLT 124 AFP, DCP, NLR Day before LT, maximum and mean values within 90 d before LT Tumor ≥ 5, MVI, mean NLR and maximum AFP and DCP before LT Tokyo criteria, AFP > 250 and DCP > 450 (one point each)
Lai et al[78], 2014 Belgium DDLT 146 AFP > 200, NLR > 5.4, PLR > 150 At inclusion on the waiting list, at LT, AFP, NLR and PLR in univariate analysis No
Parisi et al[79], 2014 UK DDLT 150 NLR ≥ 5, PLR ≥ 150, IBI score Day of LT Absence of neoadjuvant therapy, beyond Milan criteria on explant No
Harimoto et al[99], 2016 Japan LDLT 190 DCP ≥ 300, NLR ≥ 2.66, PLR ≥ 70.4, CRP ≥ 0.27 Not specified NLR, DCP, and tumor number ≥ 5 No
Wang et al[97], 2016 China DDLT/LDLT 248 NLR continuous, AFP > 400 Within 1 wk before LT NLR , AFP > 400, age, tumor number and size Model TFS: 1.094 × tumor number (≤ 3, 0 points; > 3 (1 point) + 0.094 × maximum tumor diameter + 0.754 × AFP (≤ 400, 0 points; > 400, 1 point) + 0.085 × NLR -0.024 × age
Halazun et al[98], 2017 United States DDLT/LDLT 339 NLR ≥ 5, AFP NLR at day of LT; serial AFP at HCC diagnosis, before pre-LT treatment and at LT. Tumor size and number, NLR ≥ 5, maximum pre-LT AFP, vascular invasion and poor differentiated tumors MoRAL score: (1) pre-MoRAL: NLR ≥ 5 (6 points) + AFP > 200 (4 points) + largest tumor size > 3 cm by imaging (3 points); (2) post-MoRAL: grade IV tumors (6 points) + vascular invasion (2 points) + tumor size > 3 on pathology (3 points) + tumor number > 3 on pathology (2 points); and (3) combined score.
Fu et al[100], 2018 China LDLT 150 NLR, PLR, MLR, SII Within 1 wk before LT No association No

AFP: Alpha-fetoprotein; CRP: C-reactive protein; DCP: Des-gamma-carboxyprothrombin; DDLT: Deceased donor liver transplantation; IBI: Inflammation based index; LDLT: Living donor liver transplantation; LT: Liver transplantation; MVI: Microvascular invasion; NLR: Neutrophil-to-lymphocyte ratio; PLR: Platelet-to-lymphocyte ratio; SII: Systemic inflammation index; TFS: Tumor-free survival.