Hydrogen Gas Shows Promise for Liver Preservation in Transplant Surgery
- Authors
- Moto Fukai, Sodai Sakamoto, Hiroki Bochimoto, Nur Khatijah Mohd Zin, Kengo Shibata, Takahisa Ishikawa, Shingo Shimada, Norio Kawamura, Masato Fujiyoshi, Sunao Fujiyoshi, Nakamura Kosei, Tsuyoshi Shimamura, Akinobu Taketomi
- Journal
- Transplantation Proceedings
- Year
- 2023
- DOI
- 10.1016/j.transproceed.2023.02.036
- Study Type
- Rat
- Outcome
- Positive
- Peer Reviewed
- Yes
- Country
- Japan
- Health Condition
- End-Stage Liver Disease
- Body System
- Hepatic
TL;DR
Adding hydrogen gas to a special cold preservation method for rat livers donated after death improves some aspects of liver health and structure.
Key Finding
Hydrogen gas added during machine preservation reduced cell death and preserved cellular structures in rat livers, but did not restore critical liver functions like bile production or oxygen consumption.
Summary
Researchers tested whether adding hydrogen gas to a machine that preserves donor livers (from donors who had stopped breathing) could reduce damage during storage and improve function after transplant. In rat livers, hydrogen gas reduced certain types of cell death and preserved the internal structures of cells, but it did not improve the liver's ability to produce bile or use oxygen—key measures of whether a liver would actually work after transplant.
Practical Takeaway
This early-stage rat study suggests hydrogen gas may help protect liver cells during the preservation process, but it was not enough to restore full organ function. Much more research is needed before this approach could be tested in humans, and the findings highlight that reducing cell damage alone may not be sufficient for successful organ transplantation.
Abstract
Background: We have previously reported the efficacy of post-reperfusion H2 gas treatment in cold storage (CS) and subsequent reperfusion of the rat liver. The present study aimed to evaluate the effect of H2 gas treatment during hypothermic machine perfusion (HMP) in rat livers retrieved from donation after circulatory death (DCD) and elucidate the mechanism of action of H2 gas. Methods: Liver grafts were procured from rats after 30 min of cardiopulmonary arrest. The graft was subjected to HMP for 3 hours at 7°C using Belzer MPS with or without dissolved H2 gas. The graft was reperfused using an isolated perfused rat liver apparatus at 37°C for 90 minutes. Perfusion kinetics, liver damage, function, apoptosis, and ultrastructure were evaluated. Results: Portal venous resistance, bile production, and oxygen consumption rates were identical in the CS, MP, and MP-H2 groups. Liver enzyme leakage was suppressed by MP (vs control), whereas H2 treatment did not show a combination effect. Histopathology revealed poorly stained areas with a structural deformity just below the liver surface in the CS and MP groups, whereas these findings disappeared in the MP-H2 group. The apoptotic index in the CS and MP groups was high but decreased in the MP-H2 group. Mitochondrial cristae were damaged in the CS group but preserved in the MP and MP-H2 groups. Conclusions: In conclusion, HMP and H2 gas treatment are partly effective in DCD rat livers but insufficient. Hypothermic machine perfusion can improve focal microcirculation and preserve mitochondrial ultrastructure.