Certainty for clinicians and improved safety for liver patients
LiMAx is a non-invasive diagnostic test carried out at the patient’s bedside. It is based on the metabolic turnover of 13C-labelled methacetin solution for intravenous injection and produces a quantitative measurement of maximal liver function capacity. This reveals liver metabolic function at cellular level in real-time, which correlates with liver disease severity and loss of liver volume following resection.
The LiMAx test is currently used to:
- Improve the clinical care pathway for patients who have primary liver cancer, or who have metastasized colorectal cancer and are planned to undergo liver surgery
- Stratify patients with suspected liver disorders
The benefits of LiMAx®
The LiMAx test results allow physicians to stratify patients according to their liver function capacity. This can be used to assess current status in patients with liver diseases, select appropriate patients for liver resection and plan their treatment, and optimize postoperative support. It can easily be implemented into clinical routine.
The LiMAx test results can assist clinicians to:
- Refine diagnosis
- Assess liver disease severity
- Predict prognosis
- Monitor therapy efficacy
Liver disease: a background
Liver diseases are the fifth major cause of death worldwide. A range of hepatic conditions, including non-alcoholic liver disease (NAFLD), non-alcoholic steatohepatitis (NASH), fibrosis, cirrhosis, and age-related liver disorders are linked with impaired liver function as well as capability of liver regeneration, which results in increased morbidity and mortality in response to surgery of hepatocellular carcinoma (HCC), liver transplantation or toxic chemicals.
For primary or metastatic hepatic malignancies, hepatectomy is the treatment of choice, but the resection of functional liver parenchyma is associated with the risk of developing post-hepatectomy liver failure (PHLF). Successful liver resection as treatment of choice in patients with primary or metastatic liver tumors requires postoperative hepatic regeneration to meet metabolic demand. However, certain hepatic conditions may impair liver regeneration and functional capacity required to maintain the homeostatic function of the liver. The incidence of PHLF after partial liver resection ranges between 1 and 9%, and is closely associated with prognosis and patient outcome. The mortality rates stemming from PHLF can be up to 50%.
Predicting surgical outcome is therefore becoming increasingly important to improve prognosis and ensure patient safety.
1 Lock, J. F., et al. The costs of postoperative liver failure and the economic impact of liver function capacity after extended liver resection – a single-center experience. Langenbeck's Archives of Surgery 394.6 (2009): 1047-1056.
2 Stockmann M et al., The LiMAx test: a new liver function test for predicting postoperative outcome in liver surgery, Hpb 12.2 (2010):139-146.
Device development was supported by