Prognostic value of the monoethylglycinexylidide liver function test in assessing donor liver suitability

Background: Liver graft assessment prior to transplantation continues to be controversial. Various donor organ parameters must be evaluated to ensure that the transplanted organ will function and that the number of organs discarded will be minimized. Recent attempts to quantify liver function have utilized the metabolism of lidocaine to monoethylglycinexylidide (MEGX), and the MEGX test has been employed to evaluate the functional characteristics of donor livers prior to transplantation, with conflicting results. Objective: To ascertain the role of quantitating the metabolic rate of lidocaine in predicting the results of liver transplantation. Methods: Consecutive liver donors (N=37) underwent quantitation of the amount of lidocaine converted to MEGX at 15 minutes. The donor patients were divided arbitrarily into efficient and poor lidocaine me tabolizers, and the results of liver transplantation were evaluated. Results: Patients who received livers that produced MEGX values of 80 ng/mL or less in 15 minutes had no definable alteration in transplantation outcome compared with patients who received livers that were more efficient lidocaine metabolizers. In a collected series, 46 patients who received livers that produced MEGX values of 80 ng/mL or less had a 1-month graft survival rate of 89% (41/46), while 74 patients who received livers that produced MEGX values greater than 80 ng/mL had a 1- month graft survival rate of 86% (64/74). Conclusions: The MEGX test had no practical utility in predicting liver graft functional status.