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Early assessment of transplanted liver function: Lignocaine clearance test (MEGX)

  • G. Freys (a1), T. Pottecher (a1), B. Calon (a1), G. Hamel (a2), L. Pain (a1), K. Boudjema (a3) and J. C. Otteni (a1)...

Abstract

The purpose of this study was to assess the value of lignocaine biotransformation into monoethylglycinexylidide (MEGX) and conventional liver function tests in the early post-operative period as an indicator of graft function and as a diagnostic tool for complications after hepatic transplantation. Monoethylglycinexylidide formation, plasma bilirubin, aspartate aminotransferase (ASAT), alanine amino- transferase (ALAT), factor V index (FVI) and prothrombin time index (PTI) were measured in 71 patients undergoing 80 liver transplantations respectively at 12 (T1), 24 (T2), 48 (T3) and 72 h (T4) after liver graft revascularization. Patients were divided into two group according to the post-operative outcome. Patients with favourable outcome (n = 59) had significantly higher monoethylglycinexylidide synthesis, higher factor V index and prothrombin time index plasma concentrations, lower bilirubin, ASAT and ALAT plasma concentration (P < 0.0001 at T2 and T3) than those with 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 combination of parameters at T2 was a very efficient predictor of primary non function, acute rejection and an uncomplicated time course.

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Corresponding author

Correspondence: Dr G. Freys, Surgical Intensive Care Unit, University Hospital Strasbourg Hautepierre, F-67098 Strasbourg Cedex.

Keywords

Early assessment of transplanted liver function: Lignocaine clearance test (MEGX)

  • G. Freys (a1), T. Pottecher (a1), B. Calon (a1), G. Hamel (a2), L. Pain (a1), K. Boudjema (a3) and J. C. Otteni (a1)...

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