Can Preoperative Fibrinogen-Based Ratios and Hemogram-Derived Indices Predict Early Adverse Events, 6-Month Mortality, and Perioperative Bleeding in Liver Transplant Recipients? A Retrospective Single-Center Study.

Background

This study evaluated whether preoperative fibrinogen-based ratios and hemogram-derived indices predict early adverse events, 6-month mortality, and perioperative bleeding in liver transplant recipients.

Methods

In this retrospective single-center cohort (n = 65), early outcome was defined as a 7-day composite of major complication and/or death. The primary endpoint was 6-month mortality. Logistic regression and ROC analyses were performed.

Results

Six-month mortality occurred in 18.5% and early adverse events in 20.0% of patients. Age independently predicted both 6-month mortality (OR 1.11, p = .023) and early adverse outcomes (OR 1.13, p = .007; AUC = 0.782). The fibrinogen-to-albumin ratio was independently associated with 6-month mortality (OR 1.02, p = .045) with moderate discrimination (AUC = 0.704; NPV 89.2%). Operative duration was also independently associated with mortality (AUC = 0.756). Traditional severity scores were not predictive. Correlations between fibrinogen-based indices and bleeding (cell saver volume) were weak (|r| < 0.30).

Conclusions

Age was the most consistent predictor of both 7-day composite adverse outcomes and 6-month mortality. The fibrinogen-to-albumin ratio was independently associated with 6-month mortality, whereas its relationship with bleeding was limited. Perioperative factors appeared more influential than baseline laboratory-derived indices.