Abstract

BackgroundDelayed graft function (DGF) can affect short- and long-term allograft outcomes in kidney transplant recipients. One of the pathophysiological pathways in the occurrence of DGF is ischemia-reperfusion injury (IRI). High dose intravenous vitamin C has proven efficacy in decreasing IRI consequences. Accordingly, we designed this study to assess the effect of high dose intravenous vitamin C on the incidence and duration of DGF.MethodsThis is a pilot, single-center, double-blinded, randomized, placebo-controlled trial. In the treatment group, kidney transplant recipients received vitamin C infusion at the dose of 70 mg/kg diluted in 0.45% saline, and in another study arm, only the diluent solution was administered. Data regarding allograft function and other clinical information was recorded.ResultsThis preliminary study on 19 patients (9 cases in the vitamin C and 10 cases in the placebo group) showed that after administration of single, high dose vitamin C the incidence of DGF was not significantly different between the groups, but the duration of DGF was substantially shorter in the vitamin C group than the placebo group (7.33 ± 5.68 versus 19.66 ± 0.57 days; P = 0.02). Acute rejection episodes were more seen in the vitamin C group than in the placebo group. Although this data was not statistically significant (P = 0.37), it led to the termination of the study.ConclusionA high dose of intravenous vitamin C before allograft implantation was effective in decreasing DGF duration but not DGF incidence.Trial registrationThe trial was registered in the Iranian registry of clinical trials encoded IRCT20100111003043N13 on June 24, 2019.

Highlights

  • Delayed graft function (DGF) is one of the early complications after kidney transplantation

  • DGF incidence did not differ between the vitamin C and placebo groups based on both dialysis criteria and all criteria mentioned in the method section

  • The DGF duration was significantly shorter in the vitamin C group (P = 0.02)

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Summary

Introduction

Delayed graft function (DGF) is one of the early complications after kidney transplantation. The need for undergoing dialysis therapy within the first week after transplantation is the most practical definition of DGF. DGF occurrence affects the short- and long-term transplantation outcomes, graft rejection, and patients’ and organs’ survival [4]. Therapeutic interventions to reduce the incidence of DGF are administered either before or after transplant surgery on harvested organ or recipient. The use of anti-inflammatory, vasodilator, and immunosuppressant drugs have been the most common studied treatments on transplant recipients [2]. Delayed graft function (DGF) can affect short- and long-term allograft outcomes in kidney transplant recipients.

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