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The most simple thing that almost every single person has gotten done but no one's looked at is their lymphocyte to monocyte ratio on their CBC

The fundamental event that underlies the complex pathophysiology and multi-systemic consequences of SCD is the polymerization of HbS that occurs under low oxygen tension (Figure 2)

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They hint at a narrow therapeutic window in a biologically distinct subgroup: younger patients, usually with alcohol-related disease, higher baseline MELD-3 but preserved albumin, and clear evidence of systemic inflammation (higher CRP) in whom improvements in inflammatory markers parallel meaningful improvements in MELD-3 and outcomes