Hydrogen Gas Improves Donated Lungs Before Transplant Surgery
- Authors
- Seokjin Haam, Jin Gu Lee, Hyo Chae Paik, Moo Suk Park, Beom Jin Lim
- Journal
- The Journal of Heart and Lung Transplantation
- Year
- 2018
- DOI
- 10.1016/j.healun.2018.06.007
- Study Type
- Pig
- Outcome
- Positive
- Peer Reviewed
- Yes
- Country
- South Korea
- Health Condition
- Lung Transplant Recipients
- Body System
- Respiratory
TL;DR
Breathing in hydrogen gas during a special lung treatment before transplant helps improve the function of donated lungs after the donor's heart has stopped beating.
Key Finding
Lungs ventilated with 2% hydrogen gas during preservation showed significantly better function, reduced inflammation and cell death, and less fluid accumulation compared to lungs ventilated with room air, with benefits persisting after transplantation.
Summary
Researchers tested whether adding hydrogen gas to the air used to ventilate donor lungs during preservation could improve their function before transplantation. In a study using pigs, lungs treated with 2% hydrogen gas showed better oxygen exchange, less inflammation, less cell death, and less fluid buildup in the lung tissue compared to lungs treated with regular air. These improvements remained visible even after the lungs were transplanted into recipient animals.
Practical Takeaway
This is an early-stage animal study suggesting hydrogen gas may help preserve donor lungs for transplantation by reducing damage. However, this research has not been tested in humans, and the findings cannot yet be applied to hydrogen water or other consumer hydrogen products. Much more research would be needed to determine if this approach could benefit transplant patients.
Abstract
Background: Ex vivo lung perfusion (EVLP) is a system that circulates normothermic perfusate into procured lungs, allowing for improved lung function and lung assessment. We investigated whether ventilation with hydrogen gas during EVLP improves the donation after cardiac death lung function and whether this effect persists after actual transplantation. Methods: Ten pigs were randomly divided into a control group (n = 5) and a hydrogen group (n = 5). No treatment was administered to induce warm ischemic injury for 1 hour after cardiac arrest, and EVLP was applied in procured lungs for 4 hours. During EVLP, the control group was given room air for respiration, and the hydrogen group was given 2% hydrogen gas. After EVLP, the left lung graft was orthotopically transplanted into the recipient and reperfused for 3 hours. During EVLP and reperfusion, the functional parameters and arterial blood gas analysis (ABGA) were measured every hour. Superoxide dismutase, heme oxygenase, interleukin (IL)-6, IL-10, tumor necrosis factor-α, and nucleotide-binding oligomerization domain-like receptor protein 3 were evaluated in lung tissue after reperfusion. Pathologic evaluations were performed, and the degree of apoptosis was evaluated. The wet/dry ratio was measured. Results: During EVLP and reperfusion, functional parameters and ABGA results were better in the hydrogen group. The expressions of superoxide dismutase (p = 0.022) and heme oxygenase-1 (p = 0.047) were significantly higher in the hydrogen group. The expressions of IL-6 (p = 0.024) and nucleotide-binding oligomerization domain-like receptor protein 3 (p = 0.042) were higher in the control group, but IL-10 (p = 0.037) was higher in the hydrogen group. The lung injury severity score and the number of apoptotic cells were higher and the degree of pulmonary edema was more severe in the control group than in the hydrogen group. Conclusions: Hydrogen gas inhalation during EVLP improved donation after cardiac death lung function via reduction of inflammation and apoptosis, and this effect persisted after LTx.