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Selection criteria for liver transplant donors
T J Schroeder1, A J Pesce, F C Ryckman
1University of Cincinnati Medical Center, Department of Pathology, Ohio 45267-0714.
Journal of Clinical Laboratory Analysis
|January 1, 1991
Summary
The monoethylglycinxylidide (MEGX) test may improve donor selection for liver transplantation. Utilizing MEGX could increase the number of viable organ donors, addressing the critical shortage.
Area of Science:
- Hepatology
- Transplant Surgery
- Clinical Chemistry
Background:
- Increasing liver transplant success has led to a donor organ shortage.
- Approximately 25% of patients die awaiting a suitable liver donor.
- Current donor assessment criteria require re-evaluation.
Purpose of the Study:
- To evaluate the utility of the monoethylglycinxylidide (MEGX) test in assessing potential liver donors.
- To determine if MEGX testing can identify suitable donors rejected by standard criteria.
Main Methods:
- Standard liver function tests (LFTs) were performed on 56 potential donors.
- A lidocaine metabolism test measuring MEGX accumulation at 15 minutes was conducted.
- Donors were categorized into transplanted (Group I) and unacceptable (Group II) groups.
Main Results:
- All 34 transplanted donors (Group I) had MEGX values > 50 ng/mL.
- 22 donors (39%) were deemed unacceptable based on LFTs, age, instability, or other factors.
- Six of seven donors excluded in Group I and nine of 12 in Group II (excluding LFTs) had acceptable MEGX values.
Conclusions:
- Standard LFTs may not fully capture donor viability.
- MEGX testing shows promise in identifying potentially transplantable donors rejected by conventional criteria.
- Revising donor selection criteria with tests like MEGX may help alleviate organ shortages.