LiMAx system for assessing the functional capacity of the liver

The technology described in this briefing is the LiMAx liver function capacity test. It is intended to predict post-operative outcomes in people who are being considered for liver surgery or liver transplant, to allow individualised management mainly by informing the surgeon on the extent of resectability.

The innovative aspects are that it offers point-of-care measurement of a novel marker of liver function.

The intended place in therapy would be as well as standard tests and investigations in people being considered for liver surgery or transplant.

The main points from the evidence summarised in this briefing are from 6 studies (1 randomised control trial and 5 observational studies) including over 1,700 adults with primary or secondary liver tumours having liver surgery and 266 liver transplant candidates. They show that LiMAx is useful for preoperative risk stratification and can help predict the likelihood of post-operative liver failure and mortality risk before surgery.

Key uncertainties around the evidence or technology are how generalisable the results are to NHS practice because all available evidence is from the German healthcare system, and most are from 1 centre. There is less evidence on its use in liver transplants.

The cost of each LiMAx test is £341 (excluding VAT) assuming a minimum annual usage of 50 tests. The resource impact would be an additional cost to current practice. If the test were to accurately predict post-operative outcomes, there could be savings from reductions in post-operative complications and reduced length of stay.