Antioxidant doubles liver transplant success rate

Sunday, March 17, 2013 by: David Gutierrez, staff writer
Tags: liver transplants, antioxidants, NAC

(NaturalNews) The success of liver transplants and the survival of transplant patients can be dramatically improved by injecting livers with an antioxidant prior to surgery, according to a study conducted by researchers from Padova University in Italy and published in the journal Liver Transplantation. The effect is particularly striking in "suboptimal" livers, such as those harvested from deceased organ donors.

"Liver transplantation is the standard treatment for end-stage liver disease," lead author Francesco D'Amico said. According to the World Health Organization, a total of 22,000 liver transplants were performed globally in 2010, and almost 18,500 of those livers were supplied by deceased donors.

Yet, liver transplantation can be a risky process, especially when the liver comes from a deceased donor. Studies have shown that when a liver is harvested for donation, its oxygen supply is interrupted. When blood supply is returned for storage and preservation, these livers may suffer damage that dramatically increases the risk of later transplant failure.

According to the study; however, an antioxidant known as N-acetylcysteine (NAC) may prevent this damage and improve patient outcomes.

"Antioxidants such as NAC could potentially reduce damage to deceased donor livers, improving graft function," D'Amico said.

Striking drop in death rate

The study was performed on 140 adults undergoing their first liver transplants. In half of the transplant cases, the livers were injected with 30 mg/kg of NAC one hour before procurement, plus another 150mg/kg through the portal vein before cross-clamping. In the control group, the livers underwent no treatment before transplantation.

Three months after transplantation, the percentage of patients with functioning transplanted livers ("graft survival rate") was 93 percent in the antioxidant group, compared with 82 percent in the control group. At 12 months, the graft survival rate in the control group had fallen to 70 percent, but was still 90 percent in the antioxidant group. Similarly, only 23 percent of antioxidant patients suffered from complications, compared with 51 percent in the control group.

Antioxidant treatment also dramatically improved patient survival. Three months after surgery, 99 percent of antioxidant patients were still alive, compared with only 86 percent of control patients. The survival rates among antioxidant patients were 94 percent and 90 percent at one and two years, respectively, compared with only 75 percent and 72 percent in the control group. At a follow-up approximately 33 months after surgery, only 10 patients from the antioxidant group had died, compared with 22 in the control group.

"We propose that NAC be used during organ harvesting to improve liver transplantation outcomes," D'Amico said, "particularly with the increased use of suboptimal organs. NAC has a good safety profile and the very low cost per patient, make this protocol highly cost-effective in consideration of grafts survival, length of hospital stays and post operative complications."

In an accompanying editorial, researchers from the University of California, San Francisco and OneLegacy praised the study, saying too little research has been conducted on improving outcomes in deceased donor transplants.

"Well-controlled deceased donor research is crucial to uncovering superior clinical practices that improve organ utilization and transplant outcomes," they wrote.

Sources:

http://www.sciencedaily.com/releases/2013/02/130225102531.htm
http://www.medpagetoday.com/Transplantation/LiverTransplantation/37483