To evaluate the application and efficacy of prospective interventional strategies based on multi-dimensional evaluation in the perioperative period of liver transplantation for liver cancer.

Clinical data of 100 liver cancer patients who underwent liver transplantation in the Third Affiliated Hospital of Sun Yat-sen University from February 2023 to March 2025 were analyzed retrospectively. The informed consents of all patients were obtained and the local ethical committee approval was received. Among them, 79 patients were male and 21 female, aged from 16 to 70 years, with a median age of 53 years. All patients were divided into the perioperative prospective intervention group (intervention group, n=50) and control group (n=50). In the control group, patients received conventional management in perioperative period of liver transplantation, and their counterparts in the intervention group were additionally given with perioperative prospective interventions besides those in the control group. The core of prospective interventions during perioperative period was to build a specialized management team, integrate multidisciplinary team resources such as surgeons, anesthesiologists, ICU physicians, nursing teams, rehabilitation physicians, nutrition physicians and psychologists, and jointly formulate definite and standardized objectives and procedures. Sequential organ failure assessment (SOFA score), venous thromboembolism risk assessment (Caprini score), fall risk assessment (Morse fall scale), Braden scale for predicting pressure ulcer risk (Braden scale), independence in activities of daily living (Barthel index), psychological stress assessment (PHQ-9), nutritional risk score (NRS 2002) and the length of hospital stay between two groups were compared using t-test. The incidence of postoperative complications was compared by Chi-square test.

In the intervention group, the SOFA, Caprini, Morse, PHQ-9 and NRS 2002 scores were 4.9±2.7, 3.1±0.8, 36±11, 2.5±2.0 and 2.5±1.1, significantly lower than 6.6±3.0, 3.5±0.9, 45±8, 3.5±2.8 and 3.5±1.2 in the control group (t=-2.946,-2.628,-4.304,-2.053,-4.543; all P<0.05). In the intervention group, the Braden pressure ulcer score was 17.4±1.4, significantly higher than 16.7±1.5 in the control group (t=2.258, P<0.05). However, the Barthel indexes in the intervention and control groups were 83±16 and 77±16, and the difference was not statistically significant (t=1.968, P>0.05). In the intervention group, the length of hospital stay was (28±9) d, significantly shorter than (41±22) d in the control group (t=-3.929, P<0.05). The incidence of postoperative complications in the intervention group was 28%(14/50), significantly lower than 48%(24/50) in the control group(χ²=4.244, P<0.05).

For liver transplantation recipients with liver cancer, perioperative prospective interventions based on multi-dimensional comprehensive evaluation contribute to improving physiological and psychological status, reducing the incidence of postoperative complications, shortening the length of hospital stay, accelerating postoperative recovery and significantly enhancing clinical prognosis.