title: Effects of N-Acetylcysteine Addition to University of Wisconsin Solution on the Rate of Ischemia-Reperfusion Injury in Adult Orthotopic Liver Transplant.
abstract: OBJECTIVE
  One of the main concerns in liver transplant is the prolonged ischemia time, which may lead to primary graft nonfunction or delayed function. N-acetylcysteine is known as a hepato-protective agent in different studies, which may improve human hepatocyte viability in steatotic donor livers. This study investigated whether N-acetylcysteine can decrease the rate of ischemia-reperfusion syndrome and improve short-term outcome in liver transplant recipients.
  
  
  METHODS
  This was a double-blind, randomized, control clinical trial of 115 patients. Between April 2012 and January 2013, patients with orthotopic liver transplant were randomly divided into 2 groups; in 49 cases N-acetylcysteine was added to University of Wisconsin solution as the preservative liquid (experimental group), and in 66 cases standard University of Wisconsin solution was used (control group). We compared postreperfusion hypotension, inotrope requirement before and after portal reperfusion, intermittent arterial blood gas analysis and potassium measurement, pathological review of transplanted liver, in-hospital complications, morbidity, and mortality.
  
  
  RESULTS
  There was no significant difference between the groups regarding time to hepatic artery reperfusion, hospital stay, vascular complications, inotrope requirement before and after portal declamping, and blood gas analysis. Hypotension after portal reperfusion was significantly more common in experimental group compared with control group (P = .005). Retransplant and in-hospital mortality were comparable between the groups.
  
  
  CONCLUSIONS
  Preservation of the liver inside Univer-sity of Wisconsin solution plus N-acetylcysteine did not change the rate of ischemia reperfusion injury and short-term outcome in liver transplant recipients.
authors.affiliation: Surgical Oncology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Mohsen
authors.initials: M
authors.lastname: Aliakbarian
authors.forename: Saman
authors.initials: S
authors.lastname: Nikeghbalian
authors.forename: Sina
authors.initials: S
authors.lastname: Ghaffaripour
authors.forename: Amin
authors.initials: A
authors.lastname: Bahreini
authors.forename: Mohammad
authors.initials: M
authors.lastname: Shafiee
authors.forename: Mohammad
authors.initials: M
authors.lastname: Rashidi
authors.forename: Yaser
authors.initials: Y
authors.lastname: Rajabnejad
mesh_terms: D000111:Acetylcysteine / Q000008:administration & dosage* / Q000009:adverse effects; D000241:Adenosine / Q000008:administration & dosage / Q000009:adverse effects; D000493:Allopurinol / Q000008:administration & dosage / Q000009:adverse effects; D050377:Cold Ischemia; D004311:Double-Blind Method; D005260:Female; D005978:Glutathione / Q000008:administration & dosage / Q000009:adverse effects; D017052:Hospital Mortality; D006801:Humans; D007022:Hypotension / Q000209:etiology; D007328:Insulin / Q000008:administration & dosage / Q000009:adverse effects; D007492:Iran; D007902:Length of Stay; D016031:Liver Transplantation / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D019188:Organ Preservation Solutions / Q000008:administration & dosage* / Q000009:adverse effects; D010477:Perfusion / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D020011:Protective Agents / Q000008:administration & dosage* / Q000009:adverse effects; D011887:Raffinose / Q000008:administration & dosage / Q000009:adverse effects; D015427:Reperfusion Injury / Q000175:diagnosis / Q000209:etiology / Q000401:mortality / Q000517:prevention & control*; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D052096:Warm Ischemia
chemical_list: D007328:Insulin; D019188:Organ Preservation Solutions; D020011:Protective Agents; C055206:University of Wisconsin-lactobionate solution; D000493:Allopurinol; D005978:Glutathione; D000241:Adenosine; D011887:Raffinose; D000111:Acetylcysteine