Background and Aim: Lung transplantation is an important treatment option for patients with end-stage lung diseases, and outcomes may be influenced by nutritional status. This retrospecti-ve cohort study of 210 lung transplant candidates aimed to examine the associations of the Nut-ritional Risk Index (NRI), body mass index (BMI), and biochemical markers with functional capacity, lung function, BODE index, mortality, intensive care unit (ICU) duration, and survi-val.


Methods: This retrospective cohort study included 210 lung transplant candidates who were treated at a tertiary-level specialized training and research hospital between 2016 and 2022. The study collected biochemical measurements, Pulmonary Function Test (PFT), Six-Minute Walk Test (6MWT), bone scans, and nutritional status data. It also assessed post-transplant ICU dura-tion and albumin levels.


Results: Severe malnutrition was prevalent (approximately 46%) across all patient groups, in-cluding those listed for transplantation, those who underwent transplantation, and those who died while awaiting. Severe malnutrition was significantly associated with lower values of BMI, FVC%, FEV1, and FEV1/FVC (p<0.01). NRI was strongly correlated with these parameters and post-transplant survival (r=0.85, p<0.001). Unlike BMI and albumin when considered alo-ne, NRI remained an independent predictor of survival in multivariate models (p<0.01). Patients with hypoalbuminemia showed reduced 6MWT performance and lower NRI scores (p<0.05). Post-transplant ICU stay was prolonged in patients with severe malnutrition; however, waiting list mortality was not significantly associated with NRI after adjustment.

Conclusions: The NRI is a simple and effective nutritional screening tool for lung transplant candidates and predicts lung function and survival better than BMI or albumin alone. Routine pre-transplant nutritional optimization guided by NRI may improve post-transplant outcomes.