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

Published online by Cambridge University Press:  16 August 2006

G. Freys
Affiliation:
Anaesthesia and Surgical Intensive Care, University Hospital Strasbourg Hautepierre, F-67098 Strasbourg Cedex
T. Pottecher
Affiliation:
Anaesthesia and Surgical Intensive Care, University Hospital Strasbourg Hautepierre, F-67098 Strasbourg Cedex
B. Calon
Affiliation:
Anaesthesia and Surgical Intensive Care, University Hospital Strasbourg Hautepierre, F-67098 Strasbourg Cedex
G. Hamel
Affiliation:
Laboratory of Biochemistry, University Hospital Strasbourg Hautepierre, F-67098 Strasbourg Cedex
L. Pain
Affiliation:
Anaesthesia and Surgical Intensive Care, University Hospital Strasbourg Hautepierre, F-67098 Strasbourg Cedex
K. Boudjema
Affiliation:
Transplantation Unit, University Hospital Strasbourg Hautepierre, F-67098 Strasbourg Cedex
J. C. Otteni
Affiliation:
Anaesthesia and Surgical Intensive Care, University Hospital Strasbourg Hautepierre, F-67098 Strasbourg Cedex
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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.

Type
Original Article
Copyright
1997 European Society of Anaesthesiology

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