N-acetylcysteine in Liver Transplantation

Inclusion Criteria: * Male or female patients age of 18 years * Patients undergoing cadaveric liver transplant for the first time * Patients with normal serum creatinine \< 1- 1.2 mg/dl or creatinine clearance 97-140 ml/min and patients with mild renal dysfunction with serum creatinine of (2-2.5 mg/dl) or creatinine clearance 85-125 ml/min * All patients will sign informed consent Exclusion Criteria: * Allergy to NAC * Patients with history of asthma * Patient with fulminate hepatic failure * Re-do OLT * Simultaneous other organ transplant (i.e., pancreas, heart, and small bowel) * Pre-existing renal failure requiring hemodialysis or continuous hemofiltration and patient refusal to participate in the study. * Although, it is extremely uncommon for a patient with hepatic failure to become pregnant due to the pathological effect of hepatic failure on the reproductive system, the policy of Liver Transplantation Service at UPMC is to advise young female not to become pregnant while waiting for OLT. In addition the majority of the patients on the liver transplant waiting list at this institution are above 50 years of age. However, when a female patient of child-bearing potential is called in for OLT and there is a suspicion that she might be pregnant, a blood pregnancy test will be performed as a part of the standard of care for these patients.