Vitamin C status and oxidative profile in lung transplantation: a prospective observational study
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Published on: August 15, 2022
Francesca Gori1, Vittorio Scaravilli1,2, Fiorenza Ferrari1
1Department of Anesthesia, Critical Care and Emergency, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
Background:
Vitamin C (VitC) is a key circulating antioxidant, yet its perioperative kinetics and relationship with oxidative stress in lung transplantation (LuTx) remain undefined. This study aimed to describe perioperative trajectories of VitC and oxidative status markers in LuTx recipients, and to explore whether pre-transplant VitC status is associated with postoperative oxidative stress or early clinical outcomes.
Methods:
Serum was collected at anesthesia induction for LuTx (pre-LuTx), at intensive care unit (ICU) admission, 72 hours after LuTx (72 h post-LuTx), and LuTx on postoperative day 7 (7 d post-LuTx). VitC, total antioxidant capacity, total hydroperoxides (THs), 8-hydroxy-2'-deoxyguanosine (8-OHdG), and the Oxidative Stress Index (OSI) were quantified. Patients were classified based on pre-LuTx VitC levels: HypoC: <28 µmol/L and NormC: ≥28 µmol/L.
Results:
Twenty-one recipients were enrolled, with 8 (38%) HypoC. VitC declined over time (P<0.001) in the NormC group, while HypoC had persistently low VitC. THs and 8-OHdG increased from ICU admission to postoperative day 7 (both P<0.001), while total antioxidant capacity remained stable and below reference values. No significant differences in oxidative markers, OSI, or clinical outcomes emerged between HypoC and NormC.
Conclusions:
VitC levels fall markedly after LuTx, particularly in patients with initially adequate concentrations, but this decline does not appear to increase oxidative injury or worsen early postoperative outcomes. Larger studies are needed to identify whether specific subgroups may benefit from targeted VitC supplementation.
