Reliable assessment of liver function using LiMAx.
BACKGROUND (13)C liver function breath tests can facilitate the assessment of hepatic function in vivo and may help surgeons to identify candidates for safe liver surgery. However, their acceptance into clinical practice is dependent on evaluation of technical efficacy and repeatability. The aims of this study were to evaluate the within subject repeatability of the LiMAx (maximum liver function capacity) test in healthy individuals and in surgical patients to determine liver function in the perioperative workup. MATERIAL AND METHODS The LiMAx test, which is based on intravenous injection of (13)C methacetin at a dosage of 2 mg/kg body weight was performed in eighty six healthy subjects to determine a reference range. Twenty four subjects underwent repeat LiMAx testing the following day to assess within subject repeatability. Twenty one patients undergoing elective extra abdominal surgery under general anesthesia (GA group) received pre and post operative examinations. RESULTS The normal range of LiMAx was found to be 430 86 mg/kg/h and revealed a one sided cut off value of 315 mg/kg/h. The intraclass correlation coefficient of the repeat LiMAx tests was 0.85 (95% confidence interval 0.69 0.93) in the control group and 0.81 (95% confidence interval 0.60 0.92) in the group of patients with GA. CONCLUSIONS The LiMAx test shows excellent reproducibility in subjects with normal liver function. GA has no effect on test results.
The Journal of surgical research