Protective Effect of N-acetylcysteine on Early Outcomes of Deceased Renal Transplantation

• Published in: Transplantation proceedings Vol. 43; no. 5; pp. 1443 - 1449
• Main Authors: Danilovic, A, Lucon, A.M, Srougi, M, Shimizu, M.H.M, Ianhez, L.E, Nahas, W.C, Seguro, A.C
• Format: Journal Article
• Language: English
• Published: Amsterdam Elsevier Inc 01.06.2011; Elsevier
• Subjects: Acetylcysteine - administration & dosage; Adult; Biological and medical sciences; Cadaver; Female; Fundamental and applied biological sciences. Psychology; Fundamental immunology; Humans; Kidney Transplantation; Male; Medical sciences; Middle Aged; Surgery; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the urinary system; Thiobarbituric Acid Reactive Substances - metabolism; Tissue Donors; Tissue, organ and graft immunology; Thiol; Prognosis; Acetylcysteine; Protective factor; Antioxidant; Homotransplantation; Kidney; Medicine; Mucolytic; Treatment; Urinary system; Surgery; Evolution; Graft; Early; Protection; Cadaver; Kidney transplantation
• ISSN: 0041-1345; 1873-2623
• DOI: 10.1016/j.transproceed.2011.02.020

Abstract We investigated the effects of the antioxidant N-acetylcysteine (NAC) on early outcomes of deceased donor renal transplantation. Between April 2005 and June 2008, adult primary graft recipients of deceased renal donors were assigned to treatment ( n = 38) or control ( n = 36) groups and evaluated for 90 days and one year after renal transplantation. The treatment group received NAC orally (600 mg twice daily) from day 0 to 7 postoperatively. Renal function was determined by serum creatinine, MDRD and Cockcroft-Gault estimated GFR (eGFR), delayed graft function (DGF) and dialysis free Kaplan-Meier estimate curve. Serum levels of thiobarbituric acid reactive substances (TBARS), were employed as markers of oxidative stress. The NAC group displayed a lower mean serum creatinine during the first 90 days ( P = .026) and at 1 year after transplantation ( P = .005). Furthermore, the NAC group showed a higher mean eGFR throughout the first 90 days and at 1 year. DGF was lower among the NAC group ( P = .017) and these recipients required fewer days of dialysis ( P = .012). Oxidative stress was significantly attenuated with NAC ( P < .001). Our results suggested that NAC enhanced early outcomes of deceased donor renal transplantation by attenuating oxidative stress.