α-lipoic acid reduces postreperfusion syndrome in human liver transplantation - a pilot study

A double-blind randomized controlled trial was performed to compare the safety and efficacy of α-lipoic acid (ALA) in liver transplantation (LT). The grafts were randomized to receive ALA or placebo before the cold ischemia time. Furthermore, patients transplanted with the ALA-perfused graft receive...

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Detalles Bibliográficos
Autores: Casciato, Paola, Ambrosi, Nella Gabriela, Caro, Fiorella Yanina, Vazquez, Mónica, Müllen, Eduardo, Gadano, Adrián Carlos, de Santibanes, Eduardo, de Santibañes, Martin, Zandomeni, Marcos, Chahdi, Magali, Lazarte, Julio C., Biagiola, David A., Iaquinandi, Juan Cruz, Santofimia-Castaño, Patricia, Iovanna, Juan Lucio, Incardona, Claudio, Chuluyan, Hector Eduardo
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2018
País:Argentina
Institución:Consejo Nacional de Investigaciones Científicas y Técnicas
Repositorio:CONICET Digital (CONICET)
Idioma:inglés
OAI Identifier:oai:ri.conicet.gov.ar:11336/89751
Acceso en línea:http://hdl.handle.net/11336/89751
Access Level:acceso abierto
Palabra clave:ALPHA LIPOIC ACID
ISCHEMIA REPERFUSION INJURY
LIVER TRANSPLANTATION
POSTREPERFUSION SYNDROME
SLPI
https://purl.org/becyt/ford/3.1
https://purl.org/becyt/ford/3
Descripción
Sumario:A double-blind randomized controlled trial was performed to compare the safety and efficacy of α-lipoic acid (ALA) in liver transplantation (LT). The grafts were randomized to receive ALA or placebo before the cold ischemia time. Furthermore, patients transplanted with the ALA-perfused graft received 600 mg of intravenous ALA, while patients with the nonperfused graft received the placebo just before graft reperfusion. Hepatic biopsy was performed 2 h postreperfusion. Blood samples were collected before, during and 1 and 2 days after reperfusion. Quantitative polymerase chain reaction (qPCR) analysis was performed on biopsies to assess genes involved in the response to hypoxia, apoptosis, cell growth, survival and proliferation, cytokine production and tissue damage protection. Nine of 40 patients developed postreperfusion syndrome (PRS), but seven of them belonged to the control group. There was a decrease in PHD2 and an increase in alpha subunit of hypoxia-inducible factor-1 (HIF-1α) and baculoviral IAP repeat containing 2 (Birc2) transcript levels in the biopsies from the ALA-treated versus the control group of patients. Additionally, plasma levels of alarmins were lower in ALA-treated patients than control patients, which suggests that ALA-treated grafts are less inflammatory than untreated grafts. These results showed that ALA is safe for use in LT, induces gene changes that protect against hypoxia and oxidative stress and reduces the appearance of PRS.