Hydrogen gas inhalation during ex-vivo lung perfusion improves transplant outcomes

Further evidence that inhalation of 2% hydrogen during warm EVLP improves DCD donor lung function and post-transplant outcomes was recently reported by Haam et al from Seoul, Korea.⁽²⁾

Benefits of hydrogen reconditioning during EVLP were first reported by Noda et al ⁽³⁾ from Pittsburgh in rat lungs in 2014. The significance of their results was highlighted in the same issue of Transplantation in an editorial ⁽⁴⁾ by Prof J Dark with the comment “The effects of hydrogen as an antioxidant, anti-inflammatory, and antiapoptotic agent are only just now being realized.”

Haam et al had previously reported similar findings in DCD porcine lungs in 2015 ⁽⁵⁾ but the latest study confirms that the benefits observed during EVLP (including lower levels of pro-inflammatory cytokines and higher levels of the free radical scavengers SOD) also translate into improved outcomes after transplantation. The authors conclude, “Hydrogen gas inhalation during EVLP improved donation after cardiac death lung function via reduction of inflammation and apoptosis, and this effect persisted after LTx.”

References:

2. Haam S et al, Hydrogen gas inhalation during ex vivo lung perfusion of donor lungs recovered after cardiac death. J Heart Lung 2018 Oct;37(10):1271-1278 (link to abstract)

3. Noda K et al, Hydrogen preconditioning during ex vivo lung perfusion improves the quality of lung grafts in rats. Transplantation. 2014 Sep 15;98(5):499-506

4. Dark J, Hydrogen in lung reconditioning–more than just inflation. 2014 Sep 15;98(5):497-8.

5. Haam S et al, The effects of hydrogen gas inhalation during ex vivo lung perfusion on donor lungs obtained after cardiac death. Eur J Cardiothorac Surg. 2015 Oct;48(4):542-7

Xvivo Insights PB-2018-11-07