EARLY ASSESSMENT OF TRANSPLANTED LIVER-FUNCTION - LIGNOCAINE CLEARANCE TEST (MEGX)

The purpose of this study was to assess the value of lignocaine biotra nsformation into monoethylglycinexylidide (MEGX) and conventional live r function tests in the early post-operative period as an indicator of graft function and as a diagnostic tool for complications after hepat ic transplantation. Monoethylglycinexylidide formation, plasma bilirub in, 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 (T-1), 24 (T-2), 48 (T-3) and 72 h (T-4) after liver graft revascular ization. Patients were divided into two group according to the post-op erative outcome. Patients with favourable outcome (n=59) had significa ntly higher monoethylglycinexylidide synthesis, higher factor V index and prothrombin time index plasma concentrations, lower bilirubin, ASA T and ALAT plasma concentration (P<0.0001 at T-2 and T-3) than those w ith 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 c ombination of parameters at T-2 was a very efficient predictor of prim ary non function, acute rejection and an uncomplicated time course.