N-acetylcysteine in pig liver transplantation from non-heart-beating donors

Lipid peroxidation due to oxygen free radicals (OFR) seems to play a major role in loss of liver graft viability after warm ischemia, preservation, an d transplantation. N-acetylcysteine (NAC) is an antioxidant that has a dire ct effect on OFR, and is also a glutathione precursor, another antioxidant, This study was designed to evaluate the efficacy of NAC in preventing isch emia-reperfusion damage of liver grafts harvested from non-heart-beating do nors. Liver transplantation was performed on pigs divided into five groups: group 1 (control group; n = 5) received livers from heart-beating donors; livers were subjected to 30 min of warm ischemia in groups 2 (n = 3, no NAC ) and group 3 (n = 3; NAC treatment); warm ischemia time lasted 60 min in g roups 4 (n = 4; no NAC) and 5 (n = 5; NAC treatment), Studied parameters in cluded graft survival for more than 3 days, aspartate aminotransferase plas ma levels, liver histology, and hepatic total glutathione concentrations, Graft survival was 100% in groups 1, 2, and 3, 0% in group 4, and 20% in gr oup 5, NAC treatment did not influence initial mean aspartate aminotransfer ase release which was greater in warm ischemic livers than in controls. NAC treatment had no effect on liver hepatic total glutathione after reperfusi on of animals receiving warm ischemic grants. Finally, no effect on liver h istology was observed with NAC treatment. Our study suggests that in liver transplantation from non-heart-beating don ors, NAC has no effect in both graft viability and lipid peroxidation, The role of OFR in primary dysfunction of transplanted warm ischemic livers rem ains controversial.