Use of N-Acetylcysteine During Liver Procurement

February 15, 2013 updated by: Prof. Umberto Cillo, Azienda Ospedaliera di Padova

Infusione Sistemica e Loco-regionale di N-Acetilcisteina Nel Prelievo di Fegato: Uno Studio Prospettico Randomizzato Controllato. Fase II.

Randomized prospective study on the impact on the post-LT outcome by the infusion of N-acetylcysteine (NAC) during the liver procurement procedure, as an anti-oxidant agent to reduce the ischemia-reperfusion damage of organs for liver transplantation (LT).

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

Anti-oxidant agents have the potential to reduce the ischemia-reperfusion damage of organs for liver transplantation (LT). In this randomized prospective study, we seek to study the impact on the post-LT outcome of the infusion of N-acetylcysteine (NAC) during the liver procurement procedure.

Potential grafts, assigned to adult candidates with chronic liver disease enlisted for first LT, will randomly be included in a one-to-one ratio with a sequential closed envelope single-blinded assignation procedure to either the NAC protocol or in the standard procedure (without NAC).

The NAC protocol comprises: a systemic NAC infusion (30 mg/kg) one hour before the beginning of liver procurement; a loco-regional NAC infusion (300 mg through the portal vein) just before cross-clamping.

Study Type

Interventional

Enrollment (Actual)

140

Phase

  • Phase 2

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Italy
      • Padova, Italy, 35128
        • Azienda Ospedaliera Di Padova

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

18 years and older (Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • all consecutive subjects with chronic liver disease undergoing first Liver Transplantation receiving deceased donor livers

Exclusion Criteria:

  • recipients with acute liver disease;
  • paediatric patients or adult patients receiving a liver from a paediatric donor;
  • patients undergoing multiple-organ transplantation;
  • patients undergoing re-transplantation of the Liver;
  • patients undergoing living donor Liver Transplantation

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Prevention
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: NAC procurement protocol
The allocated organ, in addition to the standard procedure, was treated with a systemic NAC infusion before initiating the liver harvesting procedure, and a loco-regional infusion into the portal vein before cross-clamping.
Drug: N-acetylcystein
15 min systemic NAC infusion of the donor (30 mg/kg, maximum dose 3000 mg) diluted into 500 ml 5 % glucose solution, 30 min before initiating the liver harvesting procedure, and a loco-regional infusion (150 mg/kg of estimated liver weight, maximum dose 300 mg) into the portal vein 5 min before cross-clamping.
Other Names:
  • Fluimucil (Zambon, Italy)
  • ACC (Hexal AG)
  • Acemuc (Betapharm, Germany)
  • Acetyst (Ristert, Germany)
  • Acetadote (Cumberland Pharmaceuticals)
  • Asist (Bilim Pharmaceuticals, Turkey)
  • Brunac eyedrops (Bruschettini, Italy)
  • Fluimukan (Lek, Slovenia)
  • Flumil (Pharmazam, Spain)
  • Lysox (Menarini)
  • Mucinac (Cipla, India)
  • Mucohelp (Neiss Labs, India)
  • Mucolysin (Sandoz)
  • Mucomelt (Venus Remedies, India)
  • MUCOMIX (Samarth Life Sciences, India)
  • Mucomyst (Bristol-Myers Squibb)
  • Nytex (Pharos,Indonesia)
  • Parvolex (GSK)
  • PharmaNAC (BioAdvantex Pharma Inc., North America)
  • Rheunac (Tree Of Life, Israel)
  • Solmucaïne (IBSA, Switzerland)
  • Trebon N (Uni-pharma)
No Intervention: Standard procurement procedure
Allocated organ was treated according to the centre's standard procurement procedure: a modified double perfusion technique, where donor livers are gravity-perfused in situ via the aorta and portal vein with Celsior solution at 4 °C. After hepatectomy, donor livers were further perfused at the back-table with Celsior solution and then stored in conventional bags containing the same solution at 4 °C until transplantation.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Time Frame
Graft survival
Time Frame: up to 60 months
up to 60 months

Secondary Outcome Measures

Outcome Measure
Time Frame
Patient survival
Time Frame: up to 60 months
up to 60 months
Primary graft dysfunction
Time Frame: up to 60 months
up to 60 months

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Azienda Ospedaliera di Padova

Investigators

  • Study Director: Umberto Cillo, MD, Azienda Ospedaliera Di Padova
  • Principal Investigator: Francesco D'Amico, MD, Azienda Ospedaliera Di Padova

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Helpful Links

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start

December 1, 2006

Primary Completion (Actual)

July 1, 2009

Study Completion (Actual)

July 1, 2009

Study Registration Dates

First Submitted

July 12, 2011

First Submitted That Met QC Criteria

July 13, 2011

First Posted (Estimate)

July 14, 2011

Study Record Updates

Last Update Posted (Estimate)

February 18, 2013

Last Update Submitted That Met QC Criteria

February 15, 2013

Last Verified

February 1, 2013

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • 1635P

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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