Use of N-acetylcysteine During Liver Procurement: A Prospective Randomized Controlled Study.
D'Amico F, Vitale A, et al.Liver Transplantation [record in progress].
Aims
To evaluate the impact of the systemic and loco-regional infusion of N-acetylcysteine during liver procurement on the post liver transplant outcome.
Interventions
Deceased donors received a systemic N-acetylcysteine infusion (300 mg/kg given one hour before the beginning of liver procurement) and a loco-regional infusion of N-acetylcysteine (300 mg/kg through the portal vein just before cross-clamping) versus a standard harvesting procedure (without N-acetylcysteine infusion) during liver procurement.
Participants
140 recipients who had a first liver transplant from deceased donors.
Outcomes
The primary endpoint was graft survival. Secondary endpoints were patient survival, incidence of primary dysfunction, primary nonfunction, differences in transaminases and bilirubin values at postoperative day 2, 7, and 15, length of hospital stay, blood-derived transfusions, days of therapy with vasoactive amines, postoperative complications and acute rejections.
Follow-up
24 months
CET Conclusions
In this randomised controlled trial deceased heart-beating liver donors received systemic and portal N-acetylcysteine immediately prior to liver procurement. The use of N-acetylcysteine was associated with lower graft failure and improved graft survival up to 24 months. The use of N-acetylcysteine seemed to most benefit recipients of suboptimal grafts (DRI>1.8) when graft survival was analysed. Improved patient survival was seen although primary dysfunction was unchanged. Patients were blinded to group allocations but staff were not.
Data analysis
Available case analysis
Trial registration
Not reported