Hydrogen Gas Improves Kidney Survival for Transplant from Deceased Donors

Authors
Journal
International Journal of Molecular Sciences
Year
DOI
10.3390/ijms27114931
Study Type
Pig
Outcome
Positive
Peer Reviewed
Yes
Country
Canada
Health Condition
Ischemia-Reperfusion Injury
Body System
Renal

TL;DR

Hydrogen-saturated preservation solution improved kidney structure and function in an ex vivo pig model of DCD kidney transplantation.

Key Finding

In an animal model, kidneys preserved with hydrogen-saturated solution showed significantly reduced tissue damage and improved function markers compared to standard preservation, with improvements linked to activation of protective cellular pathways (Trx-1 and HO-1).

Summary

Researchers tested whether molecular hydrogen (a gas dissolved in preservation solution) could protect kidneys from damage during transplantation. Using pig kidneys that had been starved of oxygen to simulate donation-after-circulatory-death conditions, they compared kidneys preserved with regular solution versus hydrogen-enriched solution. Kidneys treated with hydrogen showed less tissue damage, better kidney function markers, and activated protective pathways in the cells compared to untreated kidneys.

Practical Takeaway

This is early-stage research in pigs, not humans, so it cannot yet inform decisions about hydrogen water for consumers. The study suggests hydrogen-enriched preservation solutions may help protect donor kidneys during transplantation, but clinical trials in humans would be needed before any medical applications could be established.

Abstract

Despite their reduced viability, kidneys from donors-after-circulatory-death (DCD) increase the pool of transplantable kidneys. Molecular hydrogen (H2) is emerging as a gas with therapeutic potential against graft injury. We investigated the effect of H2 in an ex vivo porcine model of DCD kidney transplantation. Renal arteries of male Yorkshire pigs (n = 6) were clamped in situ for 60 min to induce ischemia, and ureters and arteries were cannulated to mimic DCD kidney injury. Upon nephrectomy, kidneys were flushed with UW solution or H2-saturated UW solution and then preserved by machine perfusion at 4 °C for 4 h followed by a 4-h reperfusion period with warm autologous blood. Urine and arterial blood samples were collected hourly. H2 preserved renal architecture, evidenced by significantly reduced tubular necrosis and renal expression of damage markers, which corresponded with the downregulated renal expression of pro-inflammatory genes compared to the UW-only group (p < 0.05). H2 also markedly reduced levels of serum creatinine, BUN and intrarenal resistance, while flow rate, creatinine clearance and urine output were significantly higher, which positively correlated with Trx-1 and HO-1 expression in comparison with UW only group (p < 0.05). Improvement in renal graft quality and function is associated with Trx-1/HO-1 activation, suggesting preliminary clinical trials in kidney transplantation.