Clinical impact of the prognostic nutritional index at listing and immediately before surgery in lung transplantation
4 affiliations
- 1Department of Thoracic Surgery, The University of Tokyo Graduate School of Medicine, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655 Japan
- 2Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Higashi-ku, Fukuoka, 812-0054 Japan
- 3Department of Respiratory Medicine, The University of Tokyo Graduate School of Medicine, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655 Japan
- 4Department of Next-Generation Organ Transplantation, The University of Tokyo Graduate School of Medicine, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655 Japan
Abstract
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.
Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1007/s00595-026-03421-x.
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BibTeX
@article{yuhara2026clinical,
title = {{Clinical impact of the prognostic nutritional index at listing and immediately before surgery in lung transplantation}},
author = {Shinji Yuhara and Gouji Toyokawa and Junichi Takada and Miho Yamaguchi and Yue Cong and Takaki Akamine and Masahiro Yanagiya and Takahiro Karasaki and Mitsuaki Kawashima and Chihiro Konoeda and Yan Luo and Masaaki Sato},
journal = {Surgery Today},
year = {2026},
month = jul,
doi = {10.1007/s00595-026-03421-x},
url = {https://doi.org/10.1007/s00595-026-03421-x},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Clinical impact of the prognostic nutritional index at listing and immediately before surgery in lung transplantation
AU - Shinji Yuhara
AU - Gouji Toyokawa
AU - Junichi Takada
AU - Miho Yamaguchi
AU - Yue Cong
AU - Takaki Akamine
AU - Masahiro Yanagiya
AU - Takahiro Karasaki
AU - Mitsuaki Kawashima
AU - Chihiro Konoeda
AU - Yan Luo
AU - Masaaki Sato
PY - 2026
DA - 2026/07/24
JO - Surgery Today
DO - 10.1007/s00595-026-03421-x
UR - https://doi.org/10.1007/s00595-026-03421-x
AB - 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. Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1007/s00595-026-03421-x.
SN - 0941-1291
SN - 1436-2813
ER -