N-acetylcysteine: a novel approach to methaemoglobinaemia in normothermic liver machine perfusion.

Autor: Clarke, George, Mao, Jingwen, Fan, Yiyu, Hann, Angus, Gupta, Amita, Nutu, Anisa, Buckel, Erwin, Kayani, Kayani, Murphy, Nicholas, Bangash, Mansoor N., Casey, Anna L., Wootton, Isla, Lawson, Alexander J., Dasari, Bobby V. M., Perera, M. Thamara P. R., Mergental, Hynek, Afford, Simon C.
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Zdroj: Scientific Reports; 11/3/2023, Vol. 13 Issue 1, p1-8, 8p
Abstrakt: Extended duration of normothermic machine perfusion (NMP) provides opportunities to resuscitate suboptimal donor livers. This intervention requires adequate oxygen delivery typically provided by a blood-based perfusion solution. Methaemoglobin (MetHb) results from the oxidation of iron within haemoglobin and represents a serious problem in perfusions lasting > 24 h. We explored the effects of anti-oxidant, N-acetylcysteine (NAC) on the accumulation of methaemoglobin. NMP was performed on nine human donor livers declined for transplantation: three were perfused without NAC (no-NAC group), and six organs perfused with an initial NAC bolus, followed by continuous infusion (NAC group), with hourly methaemoglobin perfusate measurements. In-vitro experiments examined the impact of NAC (3 mg) on red cells (30 ml) in the absence of liver tissue. The no-NAC group sustained perfusions for an average of 96 (range 87–102) h, universally developing methaemoglobinaemia (≥ 2%) observed after an average of 45 h, with subsequent steep rise. The NAC group was perfused for an average of 148 (range 90–184) h. Only 2 livers developed methaemoglobinaemia (peak MetHb of 6%), with an average onset of 116.5 h. Addition of NAC efficiently limits formation and accumulation of methaemoglobin during NMP, and allows the significant extension of perfusion duration. [ABSTRACT FROM AUTHOR]
Databáze: Complementary Index
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