The
lidocaine-
monoethylglycinexylidide (
MEGX) test is used to monitor liver function in
liver transplant recipients. Serial studies have been undertaken after 155 allografts. The initial
MEGX concentration is significantly correlated with the donor
MEGX concentration. It is also influenced by the recipient's pretransplant
bilirubin concentration, being lowest among patients with very high
bilirubin levels. Use of segmental grafts is also accompanied by low
MEGX concentrations. The flow-dependent clearance of
lidocaine makes it a sensitive
indicator of disturbed liver blood flow, with decreased
MEGX concentrations occurring in hepatic artery
thrombosis and rejection and as a result of
cardiac failure and pulmonary effusions. Significant hepatic
ischemia resulting in delayed initial function or
cholestasis also is associated with low
MEGX concentrations. The initial median
MEGX concentrations were lowest among patients who required retransplantation or who died within 2 months of
allografting.