{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T13:42:54Z","timestamp":1783690974402,"version":"3.55.0"},"reference-count":37,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2022,5,29]],"date-time":"2022-05-29T00:00:00Z","timestamp":1653782400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Current Oncology"],"abstract":"<jats:p>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. 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). Patients and Method: This retrospective single-center cohort study enrolled 230 patients with HCC who underwent LDLT from 2004\u20132019 in our institute. We defined a high MELD score as \u226520. Results: The MELD &lt; 20 and MELD \u2265 20 groups comprised 205 and 25 cases, respectively. 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. The one-, three-, and five-year overall survival rates were not significantly different between the two groups (p = 0.056). In univariate analysis, a high pre-LT NLR was associated with poorer survival in the high MELD group (p = 0.029, hazard ratio [HR]: 1.07, 90% confidence interval [CI]: 1.02\u20131.13). NLR cut-off values of \u226510.7 and &lt;10.7 were predictive of mortality, with an AUC of 0.705 (90% CI: 0.532\u20130.879). The one-, three-, and five-year post-LT survival rates were significantly higher among the recipients with an NLR &lt; 10.7 than those with an NLR \u2265 10.7 (p = 0.005). Conclusions: Pre-LT MELD score \u2265 20 was associated with a higher risk of developing post-LT septic shock and mortality. The pre-LT serum NLR is a useful predictive factor for clinical outcomes in patients with HCC with high MELD scores.<\/jats:p>","DOI":"10.3390\/curroncol29060310","type":"journal-article","created":{"date-parts":[[2022,5,29]],"date-time":"2022-05-29T08:50:51Z","timestamp":1653814251000},"page":"3881-3893","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Living-Donor Liver Transplantation for Hepatocellular Carcinoma: Impact of the MELD Score and Predictive Value of NLR on Survival"],"prefix":"10.3390","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8830-3679","authenticated-orcid":false,"given":"Hao-Chien","family":"Hung","sequence":"first","affiliation":[{"name":"Department of Liver and Transplantation Surgery, Chang-Gung Memorial Hospital at Linkou, 5 Fusing St., Gueishan Dist., Taoyuan City 333, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6075-8786","authenticated-orcid":false,"given":"Jin-Chiao","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Liver and Transplantation Surgery, Chang-Gung Memorial Hospital at Linkou, 5 Fusing St., Gueishan Dist., Taoyuan City 333, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu-Chao","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Liver and Transplantation Surgery, Chang-Gung Memorial Hospital at Linkou, 5 Fusing St., Gueishan Dist., Taoyuan City 333, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chih-Hsien","family":"Cheng","sequence":"additional","affiliation":[{"name":"Department of Liver and Transplantation Surgery, Chang-Gung Memorial Hospital at Linkou, 5 Fusing St., Gueishan Dist., Taoyuan City 333, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tsung-Han","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Liver and Transplantation Surgery, Chang-Gung Memorial Hospital at Linkou, 5 Fusing St., Gueishan Dist., Taoyuan City 333, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ting-Jung","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Liver and Transplantation Surgery, Chang-Gung Memorial Hospital at Linkou, 5 Fusing St., Gueishan Dist., Taoyuan City 333, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3583-2048","authenticated-orcid":false,"given":"Hong-Shiue","family":"Chou","sequence":"additional","affiliation":[{"name":"Department of Liver and Transplantation Surgery, Chang-Gung Memorial Hospital at Linkou, 5 Fusing St., Gueishan Dist., Taoyuan City 333, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kun-Ming","family":"Chan","sequence":"additional","affiliation":[{"name":"Department of Liver and Transplantation Surgery, Chang-Gung Memorial Hospital at Linkou, 5 Fusing St., Gueishan Dist., Taoyuan City 333, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei-Chen","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Liver and Transplantation Surgery, Chang-Gung Memorial Hospital at Linkou, 5 Fusing St., Gueishan Dist., Taoyuan City 333, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6292-7694","authenticated-orcid":false,"given":"Chen-Fang","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Liver and Transplantation Surgery, Chang-Gung Memorial Hospital at Linkou, 5 Fusing St., Gueishan Dist., Taoyuan City 333, Taiwan"},{"name":"College of Medicine, Chang-Gung University, Taoyuan City 333, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,5,29]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"693","DOI":"10.1056\/NEJM199603143341104","article-title":"Liver Transplantation for the Treatment of Small Hepatocellular Carcinomas in Patients with Cirrhosis","volume":"334","author":"Mazzaferro","year":"1996","journal-title":"N. 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