The lidocaine (MEGX) test as an index of hepatic function: Its clinical usefulness in liver surgery

Background. The purpose of this study was to evaluate the clinical usefulne ss of the lidocaine lest, as an index of hepatic function, in the different fields of liver surgery. Methods. The lidocaine (MEGX [monoethylglycinexylidide]) test, which was pe rformed in 200 patients with different liver diseases and in 23 organ donor s, was compared with common laboratory tests. The MEGX value was related to postoperative complications in patients who undergo liver resection and to the survival of patients with cirrhosis who are awaiting transplantation. In organ donors, the test was related to the outcome of patients who underw ent transplantation. Results, The MEGX value was significantly higher in patients without cirrho sis compared to patients with cirrhosis (77.8 +/- 25 ng/mL vs 35.6 +/- 30 n g/mL; P < .05); among patients with cirrhosis, there was a significant diff erence between those patients classified Child A and those classified Child B and C (43.3 +/- 25 ng/mL vs 11.5 +/- 7.1 ng/mL; P < .05). The patients c lassified Child A who underwent liver resection with MEGX value less than 2 5 ng/mL had a significantly higher. rate of postoperative complications com pared with other patients (P < .001). Patients with cirrhosis who were awai ting liver transplantation and who had a MEGX value of less than 10 ng/mL h ad a life expectancy of no longer than 1 year. Conclusions. The MEGX test is a reliable index of hepatic function. Patient s carrying hepatocellular carcinoma with MEGX value of less than 25 ng/mL h ave a high risk of liver insufficiency after hepatic resection. Patients wi th decompensated cirrhosis who have an MEGX value of less than 10 ng/mL sho uld undergo transplantation as soon as possible.