The purpose of this study is to determine the usefulness of the lidocaine metabolite, monoethylglycinexylidide (MEG-X) in patients with liver disease. Because lidocaine is metabolized by the same enzyme that metabolizes cyclosporine, this test may also prove useful in determining cyclosporine pharmacokinetics in renal transplant patients. The study population includes those patients with bridging fibrosis going on to cirrhosis, patients with cirrhosis who will undergo major surgery to predict liver decompensation, as well as those with acute alcoholic hepatitis. Preliminary data reveal that patients with very low MEG-X have advanced cirrhosis while those with less advanced disease and normal patients have higher levels. It is hoped that with larger numbers, this test will help us to differentiate those patients who will require liver transplantation early as well as identify those who are at some risk for general anesthesia.
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