HALP Score Predicts Early Post-Transplant Outcomes: A 25-Year Retrospective Study on Hepatocellular Carcinoma and Liver Transplantation Outcomes.

Aim: The Hemoglobin-Albumin-Lymphocyte-Platelet (HALP) score is an immune nutritional marker associated with prognosis in various malignancies. However, its prognostic significance in liver transplantation (LT) for hepatocellular carcinoma (HCC) remains unexplored. This study investigates the prognostic impact of the HALP score on post-transplant survival and recurrence in HCC patients.

Patients and methods: A retrospective cohort study included 131 patients who underwent Liver Transplantation for HCC between 1998 and 2023. Patients were stratified into high and low HALP groups based on a threshold value of 55.689 determined via receiver operating characteristic (ROC) analysis. Overall survival (OS), disease-free survival (DFS), and perioperative mortality were analyzed using Kaplan-Meier and Cox regression models.

Results: The low HALP group exhibited significantly higher perioperative mortality (18.3% vs. 5.6%, P = .003), first-year mortality (30.0% vs. 9.9%, P = .001), and three-year mortality (48.3% vs. 22.5%, P = .001). Overall survival was significantly shorter in the low HALP group (P = .003). Multivariate analysis identified low HALP as an independent risk factor for perioperative (OR: 12.76, P = .019; HR: 11.68, P = .021), first-year (OR: 5.19, P = .005; HR: 4.22, P = .007) and third-year mortality (OR: 3.67, P = .01; HR: 2.88, P = .012).

Conclusion: The HALP score is a promising prognostic biomarker for predicting early risk in LT candidates with HCC. Integrating HALP into pre-transplant assessment may optimize patient selection and perioperative management, improving post-transplant outcomes.