Prognostic value of the monoethylglycinexylidide liver function test in assessing donor liver suitability
R. Fairchild, H. Solomon, J. Contis and D. Kaminski
Department of Surgery, St Louis University Hospital, Mo., USA.
BACKGROUND: Liver graft assessment prior to transplantation continues to be
controversial. Various donor organ parameters must be evaluated to ensure
that the transplanted organ will function and that the number of organs
discarded will be minimized. Recent attempts to quantify liver function
have utilized the metabolism of lidocaine to monoethylglycinexylidide
(MEGX), and the MEGX test has been employed to evaluate the functional
characteristics of donor livers prior to transplantation, with conflicting
results. OBJECTIVE: To ascertain the role of quantitating the metabolic
rate of lidocaine in predicting the results of liver transplantation.
METHODS: Consecutive liver donors (N = 37) underwent quantitation of the
amount of lidocaine converted to MEGX at 15 minutes. The donor patients
were divided arbitrarily into efficient and poor lidocaine metabolizers,
and the results of liver transplantation were evaluated. RESULTS: Patients
who received livers that produced MEGX values of 80 ng/mL or less in 15
minutes had no definable alteration in transplantation outcome compared
with patients who received livers that were more efficient lidocaine
metabolizers. In a collected series, 46 patients who received livers that
produced MEGX values of 80 ng/mL or less had a 1-month graft survival rate
of 89% (41/46), while 74 patients who received livers that produced MEGX
values greater than 80 ng/mL had a 1-month graft survival rate of 86%
(64/74). CONCLUSIONS: The MEGX test had no practical utility in predicting
liver graft functional status.
