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Purpose <p>The prognostic nutritional index (PNI), which is calculated from the serum albumin concentrations and lymphocyte counts, predicts the outcomes in lung transplantation (LT). This study aimed to investigate the optimal timing for assessing PNI before LT.</p> Methods <p>We analyzed 140 brain-dead LT recipients (2015–2023) in this study. The PNI was calculated at the time of transplant listing and immediately before LT. Using a cutoff value of 45, the patients were classified into high/low PNI groups and compared for overall survival. Changes in the PNI trajectories were analyzed.</p> Results <p>Multivariable analyses showed that a low PNI independently predicted mortality at listing (hazard ratio [HR], 2.82; 95% confidence interval [CI], 1.44–5.53; <i>P</i> = 0.003) and before LT (HR, 2.44; 95% CI, 1.25–4.77; <i>P</i> = 0.009). Patients with a persistently low PNI had a worse survival than those with a persistently high PNI (HR, 3.58; 95% CI, 1.62–7.91; <i>P</i> = 0.002), whereas an improvement in the PNI after listing was not significantly associated with survival.</p> Conclusion <p>PNI at both time points significantly predicted post-transplant outcomes. A trajectory analysis highlights the importance of nutritional assessment before listing, although larger studies are required to clarify the effects of nutritional changes after listing.</p>

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Clinical impact of the prognostic nutritional index at listing and immediately before surgery in lung transplantation

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年7月24日

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  • Shinji Yuhara,
  • Gouji Toyokawa,
  • Junichi Takada,
  • Miho Yamaguchi,
  • Yue Cong,
  • Takaki Akamine,
  • Masahiro Yanagiya,
  • Takahiro Karasaki,
  • Mitsuaki Kawashima,
  • Chihiro Konoeda,
  • Yan Luo,
  • Masaaki Sato

摘要

Purpose

The prognostic nutritional index (PNI), which is calculated from the serum albumin concentrations and lymphocyte counts, predicts the outcomes in lung transplantation (LT). This study aimed to investigate the optimal timing for assessing PNI before LT.

Methods

We analyzed 140 brain-dead LT recipients (2015–2023) in this study. The PNI was calculated at the time of transplant listing and immediately before LT. Using a cutoff value of 45, the patients were classified into high/low PNI groups and compared for overall survival. Changes in the PNI trajectories were analyzed.

Results

Multivariable analyses showed that a low PNI independently predicted mortality at listing (hazard ratio [HR], 2.82; 95% confidence interval [CI], 1.44–5.53; P = 0.003) and before LT (HR, 2.44; 95% CI, 1.25–4.77; P = 0.009). Patients with a persistently low PNI had a worse survival than those with a persistently high PNI (HR, 3.58; 95% CI, 1.62–7.91; P = 0.002), whereas an improvement in the PNI after listing was not significantly associated with survival.

Conclusion

PNI at both time points significantly predicted post-transplant outcomes. A trajectory analysis highlights the importance of nutritional assessment before listing, although larger studies are required to clarify the effects of nutritional changes after listing.