The goal of this clinical trial is to test the efficacy of intravenous ascorbic acid in preventing the postreperfusion syndrome in liver transplantation. The main questions it aims to answer are: * Can intravenous ascorbic acid prevent postreperfusion syndrome in liver transplantation ? * Can ascorbic acid decrease the incidence of liver graft dysfunction after liver transplantation? * Can ascorbic acid decreased the incidence of postoperative complications after liver transplantation ? Participants will receive 1.5 g of intravenous ascorbic acid diluted in 100 ml of saline or 100 ml of saline alone, during the anhepatic phase of liver transplantation before reperfusion of the new graft. Researchers will compared the incidence of postreperfusion syndrome in both groups.
Researches will compared: * Incidence of postreperfusion syndrome in liver transplantation * Changes in interleukin values and other inflammatory markers before and after transplantation * Incidence of liver graft dysfunction between groups * Incidence of acute renal failure and other complications between groups
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
QUADRUPLE
Enrollment
70
1.5 gr of ascorbic acid
100 ml of 0.9% saline solution
Hospital Universitario RAmon y Cajal
Madrid, Spain
RECRUITINGPostreperfusion syndrome
When mean arterial pressure decreases by more than 30% relative to the value at the end of the anhepatic phase and lasts for at least 1 min
Time frame: Within the first 5 minutes after reperfusion of the grafted liver
Ascorbic acid serum levels
Quantification of ascorbic acid levels before and after liver transplantation
Time frame: Immediately before induction of anesthesia and 12 hours after repercussion of the graft
Interleukin1beta (IL-1β) levels
Quantification of IL-1β before and after liver transplantation
Time frame: Immediately before induction of anesthesia and 12 hours after repercussion of the graft
Tumor Necrosis Factor-alpha (TNFα) levels
Quantification of TNFα before and after liver transplantation
Time frame: Immediately before induction of anesthesia and 12 hours after repercussion of the graft
Interleukin-6 levels (IL-6)
Quantification of IL-6 before and after liver transplantation
Time frame: Immediately before induction of anesthesia and 12 hours after repercussion of the graft
Interleukin-8 (IL-8) levels
Quantification of IL-8 before and after liver transplantation
Time frame: Immediately before induction of anesthesia and 12 hours after repercussion of the graft
Interferon gamma (IFNγ) levels
Quantification of IFNγ before and after liver transplantation
Time frame: Immediately before induction of anesthesia and 12 hours after repercussion of the graft
Primary graft dysfunction
Incidence of primary graft nonfunction and early graft dysfunction. Graft nonfunction: lack of liver function leading to death if not retransplanted Early graft dysfunction: Olthoff's criteria
Time frame: First postoperative week
Acute renal failure
Postoperative renal failure after liver transplantation as Kidney Disease Improving Global Outcomes (KDIGO) definition
Time frame: First postoperative week
Mechanical ventilation
Duration of mechanical ventilation (hours) until extubation of the patient
Time frame: Postoperative until day 30
Mortality
Mortality of any cause
Time frame: Up to day 30
Length of hospitalization
Length of stay in hospital (days)
Time frame: Through study completion (30 days)
Length of Intensive Care Unit (ICU) stay
Length of ICU stay
Time frame: Through study completion (30 days)
Duration of vasopressor support after transplantation
Duration of vasopressor or inotropic support after transplantation
Time frame: Postoperative until study completion (30 days)
Maximum dose of vasopressor support after transplantation
Maximum dose of vasopressor or inotropic support after transplantation
Time frame: Postoperative until study completion (30 days)
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