Ascorbic Acid to Prevent Postreperfusion Syndrome in Liver Transplantation (VITACTOH)

Intravenous Vitamin C for the Prevention of Postreperfusion Syndrome in Orthotopic Liver Transplantation From Deceased Donors

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

1.5 gr of ascorbic acid diluted in 100 ml of 0.9% saline solution will be administered intravenously during the anhepatic phase of liver transplantation

100 ml of 0.9% saline solution will be administered during the anhepatic phase of liver transplantation

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

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

Postoperative renal failure after liver transplantation as Kidney Disease Improving Global Outcomes (KDIGO) definition

Inclusion Criteria: Patients undergoing liver transplantation Exclusion Criteria: Pregnancy Allergy to ascorbic acid Nephrolithiasis Glucose-6-phosphate dehydrogenase (G6PD) deficiency Hyperoxaluria Hyperuricemia Haemochromatosis Sickle cell anemia Serum Creatinine > 1.2 mg/dl in women and 1.3 mg/dl in men Split liver graft Acute liver failure Living donor liver transplantation Controlled donor asystolia Treatment with: indinavir, Vitamin B12, Cyclosporine, iron, deferoxamine, disulfiram

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