Abstract
Despite tnghly effective preservation techniques, some degree of ischaemia I reperfusion injury (IR) is unavoidable during orthotopic liver transptan~tion @tn Celt injury occws both during the ischaemic period and after reperfusion '. It has been demonstrated tw repeffusion injury to non parenchymal cells is characterised by activation of Kupffer '. ~ d i v a t e d ~upffsr wits produce metiiators such as oxygen free radicals OJ . Oxygen free radicals may tm involved in the mecharusm . of graft rejection3 . Reduced g l u t a t h i i G W , mmnatty found in high concentrations in hepatocytes, protects against oxygen free radicals damage'. In this study we investigated whether pretreatment of liver grafts prior to reperfusion with GSH flush would alfect the degree of early acute rejection apter OLT. Fifty six patients undergoing OLT. Liver grafts were randomfy allocated to 4.8 ml GSH , s y r p t i by the Royal Free Hospital Pharmacy , or saline ,control, addition to 500 ml of the human albumin flush solution used prior to graft reperfusion. Protocol day 5 post operative bfopstes were taken. Biopsy specimens were interpreted by an experienced histopathologist and graded for ACR according to the Royal Free Hospital Scoring System The features used to make this assessment were mixed portal inflammation, eosinophils, endotheliitis and bile duct damage. Results:
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