Does N‐acetylcysteine improve hemodynamics and graft function in liver transplantation?

The release of toxic oxidative free radicals induced by ischemia and reperfusion may jeopardize liver graft function. N‐acetylcysteine (NAC) has shown protective effects on hypothermic and warm ischemia reperfusion liver injury in animals. NAC improves hemodynamics and survival rates in patients wit...

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Veröffentlicht in:Liver Transplantation and Surgery 1998-03, Vol.4 (2), p.152-157
Hauptverfasser: Steib, Annick, Freys, Guy, Collin, François, Launoy, Anne, Mark, Geneviève, Boudjema, Karim
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container_end_page 157
container_issue 2
container_start_page 152
container_title Liver Transplantation and Surgery
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creator Steib, Annick
Freys, Guy
Collin, François
Launoy, Anne
Mark, Geneviève
Boudjema, Karim
description The release of toxic oxidative free radicals induced by ischemia and reperfusion may jeopardize liver graft function. N‐acetylcysteine (NAC) has shown protective effects on hypothermic and warm ischemia reperfusion liver injury in animals. NAC improves hemodynamics and survival rates in patients with fulminant hepatic failure. The aim of this study was to investigate whether intraoperative treatment with NAC would improve hemodynamics and postoperative graft function in liver transplantation. Sixty patients with chronic end‐stage liver disease were included in a prospective randomized placebo‐controlled study. NAC or the same volume of 5% glucose was started during the anhepatic phase. Hemodynamic data and calculated tissue oxygenation parameters were compared throughout the procedure. Postoperative graft function was assessed by measurements of aminotransferases, prothrombin time, and monoethylglycinexylidide test over the 3 first postoperative days. Patient demographics were similar before the infusion of NAC or glucose. Hemodynamic parameters, oxygen consumption, oxygen delivery, oxygen extraction ratio, and lactates were not different throughout the procedure. One hour after the revascularization of the hepatic artery, the oxygen extraction ratio by the liver was similar (17% ± 7.6% v 17% ± 6.2%) in both groups. Postoperative graft function was comparable within the 3 first postoperative days. This study failed to show any beneficial effect of the intraoperative administration of NAC on hemodynamics and graft function in liver transplantation in patients with chronic liver disease.
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source MEDLINE; Access via Wiley Online Library; EZB-FREE-00999 freely available EZB journals; Alma/SFX Local Collection
subjects Acetylcysteine - therapeutic use
Adult
Aged
Female
Hemodynamics - drug effects
Humans
Liver - drug effects
Liver - physiology
Liver Function Tests
Liver Transplantation
Male
Middle Aged
Prospective Studies
Time Factors
title Does N‐acetylcysteine improve hemodynamics and graft function in liver transplantation?
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