Use of lidocaine metabolism to test liver function during the long-term follow-up of liver transplant recipients

Clin Transplant. 2004 Jun;18(3):235-41. doi: 10.1111/j.1399-0012.2004.00112.x.

Abstract

Background/aims: 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.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Female
  • Follow-Up Studies
  • Humans
  • Lidocaine / analogs & derivatives*
  • Lidocaine / metabolism*
  • Liver / metabolism*
  • Liver Function Tests / methods*
  • Liver Transplantation / physiology*
  • Male
  • Middle Aged
  • Prospective Studies
  • Time Factors

Substances

  • Lidocaine
  • monoethylglycinexylidide