Use of lidocaine metabolism to test liver function during the long-term follow-up of liver transplant recipients.
OBJECTIVE
The aim of this study was to assess the usefulness of the monoethylglycinexylidide (MEGX) test to monitoring the long-term function of liver allografts.


METHODS
MEGX production was measured prospectively in 60 consecutive liver transplant recipients undergoing their annual review.


RESULTS
Median MEGX values in liver recipients (54 ng/mL; range 10-146) were lower than those found in healthy controls (78 ng/mL; range 44-118). MEGX values correlated negatively with alanine aminotransferase (ALT) activity (p = 0.004) and with the overall histological score (p = 0.01), and positively with sulfobromophthalein (BSP) and indocyanine green (ICG) clearances (p = 0.0002 and p = 0.002, respectively). A stepwise decline was observed with worsening liver fibrosis, from 71 +/- 5 microg/L in patients with no fibrosis to 27 +/- 9 microg/L in patients with bridging fibrosis (p = 0.002). BSP and ICG clearances correlated more closely than the MEGX test with the overall histological score (p = 0.001 and p = 0.001, respectively) and portal fibrosis (p = 0.002 and p = 0.001).


CONCLUSIONS
The measurement of MEGX formation is a simple and non-invasive method to monitor liver graft function. It may constitute a valuable tool for assessing the degree of fibrosis.
Conti
Filoména
F
Service de chirurgie digestive, Hopital Cochin, Paris, France. filomena.conti@cch.ap-hop-paris.fr
Dousset
Bertrand
B
Cherruau
Brigitte
B
Guérin
Corinne
C
Soubrane
Olivier
O
Houssin
Didier
D
Calmus
Yvon
Y
D000293:Adolescent; D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008012:Lidocaine / Q000031:analogs & derivatives* / Q000378:metabolism*; D008099:Liver / Q000378:metabolism*; D008111:Liver Function Tests / Q000379:methods*; D016031:Liver Transplantation / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013997:Time Factors
D008012:Lidocaine; C001173:monoethylglycinexylidide