Abstract
BACKGROUND: Inflammation-immune composite markers have been increasingly investigated in various diseases, but their value in the setting of deceased donor liver transplantation remains insufficiently investigate. METHOD: A retrospective cohort study was conducted on deceased donor liver transplant recipients at Zunyi Medical University. Univariate and multivariate logistic regression analyses identified independent risk factors for major complications. A nomogram was constructed based on these factors. Model performance was evaluated using ROC curve, calibration curve, decision curve analysis, and clinical impact curve. RESULTS: Preoperative factors such as donor age, MLR, Anhepatic, Total Cholesterol, CIT, CAR, Lactate, and SII were identified as independent risk factors for postoperative complications with CD ≥ III but < IV, as well as CD ≥ IV complications. The Nomogram based on these results demonstrated good predictive ability and stability in the Bootstrap validation. CONCLUSION: Preoperative MLR and SII showed good predictive ability for postoperative complications graded as CD ≥ III but < IV, while CAR was predictive of CD ≥ IV complications and was associated with EAD and prolonged ICU stay. MLR was an independent risk factor for 90-day postoperative mortality. The nomogram of major outcomes requires further validation in multi-center studies.