Can hydrogen gas help with liver surgery recovery?

This clinical trial is testing whether hydrogen gas inhalation after liver surgery can improve recovery and quality of life. Early research suggests hydrogen may help reduce tissue damage from interrupted blood flow during surgery.

How does hydrogen gas work as a medical therapy?

Hydrogen gas acts as a selective antioxidant that neutralizes harmful oxygen molecules (reactive oxygen species) created during surgery. It may help protect healthy tissue from damage without interfering with normal cellular processes.

Is hydrogen gas inhalation safe for surgery patients?

Hydrogen gas inhalation is already approved for certain medical uses in Japan and appears to be safe. However, this study is specifically testing its safety and effectiveness for liver surgery patients.

What does this study measure after liver surgery?

Researchers measure quality of life scores, pain levels, dietary intake, liver function, inflammation markers, and daily activity levels. The main focus is on quality of life three days after surgery.

Why is liver surgery particularly suited for hydrogen therapy?

Liver surgery involves stopping and restarting blood flow, which creates harmful oxygen molecules that can damage tissue. Hydrogen gas may help neutralize these molecules and reduce surgical complications.

Hydrogen Gas May Help Liver Surgery Recovery and Quality of Life

Authors: Masaki Kaibori, Hisashi Kosaka
Journal: Trials
Year: 2021
DOI: 10.1186/s13063-021-05697-5
Study Type: Human
Outcome: Neutral
Peer Reviewed: Yes
Country: Japan
Health Condition: Liver Disease
Body System: Hepatic

TL;DR

This study aims to test whether inhaling hydrogen gas after liver surgery can improve patients' recovery and quality of life.

Key Finding

This is a protocol paper describing a planned clinical trial, not a completed study with results—the actual effectiveness of hydrogen gas inhalation after liver surgery has not yet been tested in this trial.

Summary

This study describes a plan to test whether breathing hydrogen gas after liver surgery can improve patients' quality of life and reduce liver damage. The research will compare patients who breathe hydrogen gas to those who breathe regular air after surgery, measuring their recovery using quality-of-life questionnaires, pain levels, and blood tests that show liver function. The theory is that hydrogen gas may reduce harmful molecules (called reactive oxygen species) that form when blood flow is cut off and then restored during surgery.

Practical Takeaway

While animal studies suggest hydrogen gas may help reduce surgical injury, this trial has not yet been completed or published with results. Anyone considering hydrogen therapy after surgery should wait for the actual findings from this and similar clinical trials before making decisions, and should discuss any experimental treatments with their surgeon.

Abstract

Abstract Introduction Molecular hydrogen had been considered inactive in vivo but is an antioxidant that selectively reduces highly toxic reactive oxygen species (ROS). Animal studies have reported that hydrogen gas inhalation helped alleviate cerebral and cardiac ischemia-reperfusion injuries. In humans, hydrogen inhalation therapy is presently approved as a treatment under Advanced Medical Care B in Japan (jRCTs031180352: limited to adult patients who suffered out-of-hospital cardiac arrest and are in a continuous coma) and its effectiveness is being examined in a clinical trial. The Japanese government has introduced the “Advanced Medical Care System” to promote the development of drugs and devices under governmental regulations. Advanced Medical Care B is a system designed for unapproved or off-label drugs or medical technologies used in a clinical trial setting. Hepatectomy is generally performed with repeated hepatic blood-flow occlusion and then reperfusion (ischemia and reperfusion). No report, however, has been made on ROS inhibition by hydrogen inhalation therapy or its effectiveness in post-hepatectomy patients. Hydrogen gas inhalation in the early stages after hepatectomy is anticipated to inhibit liver dysfunction by inhibiting ROS. Methods and analysis This study is a randomized, controlled, double-blind superiority trial, which will be conducted as a “specified clinical trial” in accordance with the Clinical Trials Act in Japan. Trial registration was prospectively completed before the first participant was enrolled. The subjects will be patients who will undergo hepatectomy and will be allocated randomly into group A with hydrogen gas inhalation or group B with air inhalation after hepatectomy. The study will examine if hydrogen gas inhalation improves QOL of post-hepatectomy patients. The primary endpoint is patient QOL (score of a 40-item quality of recovery questionnaire, QoR40) on postoperative day 3 and the secondary endpoints are QoR40s besides that on postoperative day 3, grade of postoperative complications (Clavien-Dindo score), level of pain (Numerical Rating Scale (NRS)), amount of dietary intake, liver function, inflammation level, 8-hydroxydeoxyguanosine (urinary 8-OHdG) level, and number of pedometer-assessed steps. Ethics and dissemination The study protocol has been approved by the Niigata University Central Review Board of Clinical Research. The findings of this study will be widely disseminated through peer-reviewed publications and conference presentations. Trial registration jRCTs 03220332. Registered on 21 January 2021