Clinical results of N-acetylcysteine after major hepatic surgery: a review.

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hepato-biliary-pancreatic surgery." href="AL_get(this,%20'jour',%20'J%20Hepatobiliary%20Pancreat%20Surg.');">J Hepatobiliary Pancreat Surg.

2008;15(5):473-8. Epub 2008 Oct 4.
Clinical
results of N-acetylcysteine after major hepatic surgery: a review.
McKay
A
, Cassidy
D
, Sutherland
F
, Dixon
E
.
Division of Surgical Oncology, University of
Calgary Tom Baker Cancer Centre, 1331-29th Street NW, Calgary, Alberta,
Canada.

BACKGROUND/PURPOSE:
Ischemia/reperfusion injury is thought to play an important role in
postoperative liver dysfunction and morbidity following major liver
surgery. N-acetylcysteine may be protective by serving as a precursor to
glutathione and replenishing intracellular stores, in addition to other
mechanisms. The purpose of this review is to summarize the clinical
evidence that N-acetylcysteine may reduce liver dysfunction and the
postoperative complications following major liver surgery.
METHODS: A
PubMed (MEDLINE) search was performed using the search terms
"N-acetylcysteine", "Mucomyst", "liver", and "surgery" to identify all
relevant articles published in English prior to February 2007. RESULTS:
Seventy-three articles were identified, and of these, there were seven
studies that involved human patients undergoing orthotopic liver
transplantation (six randomized controlled trials and one retrospective
study).
CONCLUSIONS: The evidence that routine use of N-acetylcysteine
reduces ischemia/reperfusion injury and prevents complications after
major liver surgery is not conclusive. The available studies may have
been limited by small sample sizes, and heterogeneous outcome measures
prevent conclusions being made across studies and prevent pooling of the
data. Further study with more relevant clinical endpoints and larger
sample sizes is warranted.