ALIAKBARIAN, M. et al.22 Aliakbarian M, Nikeghbalian S, Ghaffaripour S, Bahreini A, Shafiee M, Rashidi M, et al. Effects of N-Acetylcysteine Addition to University of Wisconsin Solution on the Rate of Ischemia-Reperfusion Injury in Adult Orthotopic Liver Transplant. Exp Clin Transplant Off J Middle East Soc Organ Transplant. 2017 Aug; 15(4): 432-6. https://doi.org/10.6002/ect.2014.0263 https://doi.org/10.6002/ect.2014.0263...
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Experimental and Clinical Transplantation/2017 |
To investigate whether NAC can decrease the rate of I/R syndrome and improve short-term outcomes in LTx recipients. |
Prospective, randomized, double-blind clinical trial. |
Post-perfusion hypotension was significantly higher in the experimental group, but the duration of hypotension was comparable between groups. The exact mechanism to explain this difference needs to be better understood. The question is whether the hypotension is related to using NAC or simply due to the small sample size. |
SANTIAGO, FM. et al.88 Santiago FM, Bueno P, Olmedo C, Muffak-Granero K, Comino A, Serradilla M, et al. Effect of N-acetylcysteine administration on intraoperative plasma levels of Interleukin-4 and Interleukin-10 in liver transplant recipients. Transplant Proc. 2008 Nov 1; 40(9): 2978-80. https://doi.org/10.1016/j.transproceed.2008.08.103 https://doi.org/10.1016/j.transproceed.2...
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Transplantation Proceedings/2008 |
To evaluate the effect of NAC administration on intraoperative plasma levels of the anti-inflammatory cytokines IL-4 and IL-10 during LTx. |
Prospective, randomized, double-blind clinical trial. |
Intraoperative plasma concentrations of IL-4 were much higher among NAC-treated LTx recipients than in the placebo group. Differences were significant 5 minutes before and 5 minutes after reperfusion. Plasma levels of IL-10 were similar in both groups, although a substantial increase was observed 5 minutes before reperfusion in the NAC-treated group. |
KHAN, AW. et al.99 Khan AW, Fuller BJ, Shah SR, Davidson BR, Rolles K. A prospective randomized trial of N-acetyl cysteine administration during cold preservation of the donor liver for transplantation: Original Article. Ann Hepatol. 2005 Apr 1; 4(2): 121-6. https://doi.org/10.1016/S1665-2681(19)32075-7 https://doi.org/10.1016/S1665-2681(19)32...
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Annals of Hepatology/2005 |
To study the effect of NAC administered to the organ donor before cold preservation. |
Prospective and randomized clinical trial. |
Peak serum AST levels were similar, and postreperfusion biopsy showed moderate to severe reperfusion injury in 3 recipients in the NAC group and 4 in the Control group. NAC administered during donor operation showed no protective effect on IRI. |
D'AMICO, F. et al.44 D’Amico F, Vitale A, Piovan D, Bertacco A, Ramirez Morales R, Chiara Frigo A, et al. Use of N-acetylcysteine during liver procurement: a prospective randomized controlled study. Liver Transpl. 2013;19(2):135-44. https://doi.org/10.1002/lt.23527 https://doi.org/10.1002/lt.23527...
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Liver Transplantation/2012 |
To test the impact of systemic and locoregional NAC infusions during liver procurement on post-LTx outcomes. |
Prospective and randomized study. |
Graft survival rates at 3 and 12 months were 93% and 90% in the NAC group and 82% and 70% in the control group, respectively. The incidence of postoperative complications was lower in the NAC group (23%) compared with the control group (51%). The incidence of primary liver dysfunction was lower for the NAC group (15%) versus the control group (32%). |
WEIGAND, MA. et al.55 Weigand MA, Plachky J, Thies JC, Spies-Martin D, Otto G, Martin E, et al. N-cetylcysteine attenuates the increase in α-glutathione s-transferase and circulating icam-1 and vcam-1 after reperfusion in humans undergoing liver transplantation1. Transplantation. 2001 Aug 27; 72(4): 694. https://doi.org/10.1097/00007890-200108270-00023 https://doi.org/10.1097/00007890-2001082...
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Transplantation/2001 |
To investigate the effects of NAC on α-GST, plasma cytokines, and circulating and cell adhesion molecules during LTx. Furthermore, since changes in surface expression of CD18 and CD62L on neutrophils were associated with increased serum liver enzymes postoperatively, we investigated whether NAC directly affected the expression of the stimulated adhesion molecule on human neutrophils in vitro. |
Prospective and randomized study. |
NAC inhibits the increase in α-GST and circulating ICAM-1 and VCAM-1 after graft reperfusion. This may point to a possible protective function of NAC during LTx. |
SANTIAGO, FM. et al.1313 Santiago FM, Olmedo C, Muffak-Granero K, Comino A, Villar JM, Garrote D, et al. Intraoperative pH values after N-acetylcysteine administration during liver transplantation. Transplant Proc. 2010 Oct 1; 42(8): 3164-6. https://doi.org/10.1016/j.transproceed.2010.05.130 https://doi.org/10.1016/j.transproceed.2...
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Transplantation Proceedings/2010 |
To evaluate the effect of NAC administration on intraoperative pH values during LTx. |
Prospective, randomized, double-blind study. |
Intraoperative administration of NAC during the anhepatic phase of LTx significantly decreased receptor pH values 5 and 20 minutes after reperfusion, a decrease detected 5 minutes before reperfusion. |
HILMI, IA. et al.1414 Hilmi IA, Peng Z, Planinsic RM, Damian D, Dai F, Tyurina YY, et al. N-acetylcysteine does not prevent hepatorenal ischaemia–reperfusion injury in patients undergoing orthotopic liver transplantation. Nephrol Dial Transplant. 2010 Jul 1; 25(7): 2328-33. https://doi.org/10.1093/ndt/gfq077 https://doi.org/10.1093/ndt/gfq077...
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Nephrology dialysis transplantation/2010 |
To evaluate the efficacy of NAC in improving liver graft performance and reducing the incidence of AKI post-LTx. Secondary objectives were to investigate the effect of NAC on GSH levels and to examine the relationship between GSH and AKI. |
Prospective, randomized, double-blind study. |
NAC did not affect liver graft survival and function. However, GSH levels were highly variable, with only 50% of patients receiving NAC exhibiting increased levels. |
GÓMEZ-GAVARA, C. et al.66 Gómez-Gavara C, Moya-Herraiz Á, Hervás D, Pérez-Rojas J, LaHoz A, López-Andújar R. The potential role of ffficacy and safety evaluation of N-Acetylcysteine administration during liver procurement. The NAC-400 Single Center Randomized Controlled Trial. Transplantation. 2021 Oct 105 (10): 2245. https://doi.org/10.1097/TP.0000000000003487 https://doi.org/10.1097/TP.0000000000003...
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Transplantation/2021 |
To compare the impact of NAC infusion during liver procurement on post-LTx outcomes. |
Single-center clinical trial. |
The incidence of primary dysfunction was 34%, 31% in the NAC group and 37.4% in the control group. NAC administration reduced ALT levels when cold ischemia time was longer than 6 hours. Both groups had similar oxidative metabolites (GSH/oxidized GSH and ophthalmic acid). Graft and patient survival rates at 12 months and three years were comparable between groups. |