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 |
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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. |
doi_str_mv | 10.1002/lt.500040204 |
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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.</description><identifier>ISSN: 1074-3022</identifier><identifier>EISSN: 1527-6473</identifier><identifier>DOI: 10.1002/lt.500040204</identifier><identifier>PMID: 9516568</identifier><language>eng</language><publisher>Philadelphia, PA: W.B. 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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.</description><subject>Acetylcysteine - therapeutic use</subject><subject>Adult</subject><subject>Aged</subject><subject>Female</subject><subject>Hemodynamics - drug effects</subject><subject>Humans</subject><subject>Liver - drug effects</subject><subject>Liver - physiology</subject><subject>Liver Function Tests</subject><subject>Liver Transplantation</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Prospective Studies</subject><subject>Time Factors</subject><issn>1074-3022</issn><issn>1527-6473</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1998</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kMtOwzAQRS0EKqWwY4vkDyBlnNh5rBDiLVWwKQtWkeOMwShxKtstyo5P4Bv5ElK1KjtWM9I9upo5hJwymDKA-KIJUwEAHGLge2TMRJxFKc-S_WGHjEcJxPEhOfL-Y6AynhYjMioES0Waj8nrTYeePv18fUuFoW9U7wMai9S0C9etkL5j29W9la1Rnkpb0zcndaB6aVUwnaXG0sas0NHgpPWLRtog18HlMTnQsvF4sp0T8nJ3O79-iGbP94_XV7NIDYfxSCAqXkHBhNRaZUyp4Y1Y1XmcJRJVVsg85TrHXCc5aMmquhaAkFZK8IHVyYScb3qV67x3qMuFM610fcmgXAsqm1DuBA342QZfLKsW6x28NTLkYpN_mgb7f7vK2fyv9xej43Oj</recordid><startdate>199803</startdate><enddate>199803</enddate><creator>Steib, Annick</creator><creator>Freys, Guy</creator><creator>Collin, François</creator><creator>Launoy, Anne</creator><creator>Mark, Geneviève</creator><creator>Boudjema, Karim</creator><general>W.B. 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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. 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source | MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Access via Wiley Online Library; 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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