Early assessment of transplanted liver function: lignocaine clearance test (MEGX).
The purpose of this study was to assess the value of lignocaine biotransformation into monoethylglycinexylidide (MEGX) and conventional liver function tests in the early post-operative period as an indicator of graft function and as a diagnostic tool for complications after hepatic transplantation. Monoethylglycinexylidide formation, plasma bilirubin, aspartate aminotransferase (ASAT), alanine aminotransferase (ALAT), factor V index (FVI) and prothrombin time index (PTI) were measured in 71 patients undergoing 80 liver transplantations respectively at 12 (T1), 24 (T2), 48 (T3) and 72 h (T4) after liver graft revascularization. Patients were divided into two group according to the post-operative outcome. Patients with favourable outcome (n = 59) had significantly higher monoethylglycinexylidide synthesis, higher factor V index and prothrombin time index plasma concentrations, lower bilirubin, ASAT and ALAT plasma concentration (P < 0.0001 at T2 and T3) than those with complicated time course (n = 21). Monoethylglycinexylidide synthesis was the best discriminant of a favourable outcome, whereas bilirubin and ALAT concentrations were associated with complications (bilirubin for primary non function [PNF], ALAT for acute rejection). Thus, the combination of parameters at T2 was a very efficient predictor of primary non function, acute rejection and an uncomplicated time course.
Freys
G
G
Laboratory of Biochemistry, University Hospital Strasbourg Hautepierre.
Pottecher
T
T
Calon
B
B
Hamel
G
G
Pain
L
L
Boudjema
K
K
Otteni
J C
JC
D000779:Anesthetics, Local / Q000493:pharmacokinetics*; D001711:Biotransformation; D004311:Double-Blind Method; D004798:Enzymes / Q000097:blood; D006207:Half-Life; D006801:Humans; D008012:Lidocaine / Q000031:analogs & derivatives / Q000097:blood / Q000493:pharmacokinetics*; D008111:Liver Function Tests; D016031:Liver Transplantation / Q000502:physiology*; D008875:Middle Aged; D011517:Prothrombin Time; D016896:Treatment Outcome
D000779:Anesthetics, Local; D004798:Enzymes; D008012:Lidocaine; C001173:monoethylglycinexylidide