Jara Maximilian, Malinowski Maciej, Lüttgert Katja, Schott Eckart, Neuhaus Peter, Stockmann Martin
Department of General, Visceral and Transplantation Surgery, Charité - Universitätsmedizin Berlin, Berlin, Germany.
Transpl Int. 2015 Jan;28(1):52-8. doi: 10.1111/tri.12441. Epub 2014 Sep 29.
LiMAx has been recently proposed as a new quantitative liver function test. Thus, we aimed to evaluate the diagnostic ability of LiMAx to assess short-term survival in liver transplant candidates and compare its performance to the model for end-stage liver disease (MELD) and indocyanine green plasma disappearance rate (ICG-PDR). Liver function of 167 chronic liver failure patients without hepatocellular carcinoma was prospectively investigated when they were evaluated for liver transplantation. Primary study endpoints were liver-related death within 6 months of follow-up. Within 6 months of follow-up, 18 patients died and 36 underwent liver transplantation. Median LiMAx results on evaluation day were significantly lower in patients who died (99 μg/kg/h vs. 55 μg/kg/h; P = 0.024), while median ICG-PDR results did not differ within both groups (4.4%/min vs. 3.5%/min; P = 0.159). LiMAx showed a higher negative predictive value (NPV: 0.93) as compared with ICG-PDR (NPV: 0.90) and the MELD (NPV: 0.91) in predicting risk of death within 6 months. In conclusion, LiMAx provides good prognostic information of liver transplant candidates. In particular, patients who are not at risk of death can be identified reliably by measuring actual enzymatic liver function capacity.
LiMAx最近被提议作为一种新的肝功能定量检测方法。因此，我们旨在评估LiMAx对肝移植候选者短期生存情况的诊断能力，并将其性能与终末期肝病模型（MELD）和吲哚菁绿血浆消失率（ICG-PDR）进行比较。对167例无肝细胞癌的慢性肝衰竭患者在进行肝移植评估时的肝功能进行了前瞻性研究。主要研究终点为随访6个月内的肝相关死亡。在随访6个月内，18例患者死亡，36例接受了肝移植。死亡患者评估当天的LiMAx结果中位数显著更低（99μg/kg/h对55μg/kg/h；P = 0.024），而两组的ICG-PDR结果中位数无差异（4.4%/分钟对3.5%/分钟；P = 0.159）。在预测6个月内死亡风险方面，LiMAx的阴性预测值（NPV：0.93）高于ICG-PDR（NPV：0.90）和MELD（NPV：0.91）。总之，LiMAx能为肝移植候选者提供良好的预后信息。特别是，通过测量实际的肝脏酶功能能力，可以可靠地识别出无死亡风险的患者。
