A previous pilot clinic trial had showed that treatment of the donor and recipient with a potent anti-oxidant such as α-lipoc acid (ALA) reduces the ischemia reperfusion injury (IRI) in simultaneous kidney pancreas transplantation. In kidney transplantation, delay graft function (DGF) is a critical factor that determines the early outcome of the graft. Therefore, the aim of the present work was to evaluate whether the administration of ALA to recipient and the graft could improve early clinical outcomes of kidney transplant patients.

The study included 26 kidney transplant patients. They were divided in two groups. In the group 1, patients were treated with placebo (8 patients) and received graft perfused with placebo. For the group 2, 600 mg of ALA was administered to the recipients immediately previous to the surgical procedure and the graft was perfused with 600 mg of ALA 1 hour before the surgery (18 patients). Blood samples were obtained before the surgery and every one or two day after the renal transplant. Plasma creatinine levels, MDRD, diuresis, rejections episodes, dialysis requirements and DGF were used as early clinical outcomes parameters.

For the first 4 days after transplantation, the plasma creatinine was lower while MDRD was higher for ALA-treated group than control group. The presence of DGF, define as the use of dialysis in the first postoperative week, was not different between both groups of patients. However, when DGF severity was evaluated (assessed as the number of dialysis sessions for subjects who started dialysis during the first 7 days post-transplant) there was a statistically significant difference between ALA-treated vs control group (p = 0.031, Wilcoxon matched-pairs signed rank test). Remarkably, 50 % of patients in the control group while only 1 patient in the ALA treated group (5.6 %) showed biopsy proven rejections episodes, during two weeks after transplantation.

Overall, this study shows that even though ALA treatment could not avoid DGF, it can improve the patient conditions by reducing the dialysis requirements and the early rejection episodes.

CITATION INFORMATION: Weber G, Ambrosi N, Caro F, Beltramino S, Fernández A, Cabrera I, Hilchenbach G, Fernandez D, Incardona C, Chuluyan E, Casadei D. The Treatment of the Graft and the Recipient with α-Lipoic Acid Improves the Delay Graft Function Severity in the Human Kidney Transplant. Am J Transplant. 2017;17 (suppl 3).

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