Premium
Acute cyclosporine toxicity after liver transplantation is predicted by the lidocaine monoethylglycinexylidide test in the donor
Author(s) -
Azoulay D,
Adam R,
Pham P,
Salvucci M,
Davoll S,
Bismuth H,
Debuire B,
Lemoine A
Publication year - 1997
Publication title -
liver transplantation and surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.814
H-Index - 150
eISSN - 1527-6473
pISSN - 1074-3022
DOI - 10.1002/lt.500030508
Subject(s) - medicine , toxicity , liver function tests , sepsis , lidocaine , creatinine , gastroenterology , renal function , liver transplantation , transplantation , liver function , prothrombin time , surgery , anesthesia
Cyclosporine toxicity is still a significant problem in the early period after liver transplantation. The monoethylglycinexylidide (MEGX) test performed in the donor has been suggested as a reliable test to predict liver graft function in the recipient. The MEGX test was performed in 50 consecutive donors, and the clinical course of recipients, metabolic parameters of the grafts, and cyclosporine levels were followed in detail for 10 days. Two patients died of sepsis and were excluded. Renal and/or neurological toxicity appeared in 15 of the remaining 48 patients (31%). In the 6 with neurological problems, MEGX values were low (41, 47, 50, 60, 94, and 101 micrograms/L). Nine patients had transient elevations of creatinine and urea; in 8 of these, cyclosporine levels remained in the normal range. Low MEGX values in the donors correlated with early evidence of cyclosporine toxicity ( P < .0001), reduced graft function (bile output, P = .04; prothrombin time at day 5, P = .005), and prolonged stay in the intensive care ( P = .022). The MEGX test is valuable and reflects the metabolic capacity of liver grafts. It can predict posttransplantation complications caused by cyclosporine toxicity, and further study would evaluate its incorporation into immunosuppressive protocols.