EVALUATION OF THE LIVER-FUNCTION OF CIRRHOTIC-PATIENTS BASED ON THE FORMATION OF MONOETHYLGLYCINE XYLIDIDE (MEGX) FROM LIDOCAINE

Determination of the functional hepatic reserve is still controversial . Many tests have been proposed, but the assay based on formation of t he lidocaine metabolite, monoethylglycine xylidide, seems to offer a p romising approach to this problem. In this study we evaluated the effe ctiveness of the monoethylglycine xylidide test in the clinical evalua tion of 31 cirrhotic patients submitted to three different therapeutic options (sclerotherapy, transjugular intrahepatic portosystemic shunt and surgical procedures) and in 1 patient submitted to right hepatect omy for giant hepatic angioma. We found a statistically significant di fference between Child A and C patients and between Child B and C pati ents. The test did not differentiate Child A from Child B patients. We found no correlation between the Child-Pugh score, serum bilirubin, a lbumin and prothrombin time. There were no differences among the three groups of patients that could be statistically related to their thera py. The monoethylglycine xylidide test seems to be an attractive alter native to previous methods for the evaluation of the functional hepati c reserve, but further studies are necessary to assess the prognostic value of the test in cirrhotics, to separate the independent contribut ion of portosystemic shunting and hepatocyte dysfunction to monoethylg lycine xylidide formation, and to evaluate the test as a prognostic in dex in cirrhotic patients submitted to general surgery.