Ascorbic acid in solid organ transplantation: A literature review

Ischemia/reperfusion (I/R) injury plays a pivotal role in the development of graft dysfunction and allograft rejection after transplantation. Excessive free radical production and massive consumption of endogenous antioxidants are common mechanisms underlying I/R injury and are implicated in posttransplant organ damage and reduced graft viability. Ascorbic Acid (AA) is an essential micronutrient involved in several biological processes, from antioxidative response to the modulation of apoptosis and inflammation. These properties, combined to the safety profile, low cost, and ease of administration and measurement, make AA a potential bullet for reducing I/R damage in the setting of solid organ transplantation. Although multiple preclinical and clinical studies have been performed to investigate the effectiveness of AA administration in reducing I/R injury during transplantation, its therapeutic potential remains controversial as well as the optimal dosage, timing, and combination with other antioxidants. In this review, we summarize the AA modulated metabolic pathways, focusing on its potential role in the treatment of solid organ (kidney, liver, lung, heart, and pancreas) transplantation.