Abstract
Various methods have been devised to dissolve hydrogen gas in organ preservation solutions, including use of a hydrogen gas cylinder, electrolysis, or a hydrogen-generating agent. However, these methods require considerable time and effort for preparation. We investigated a practical technique for rapidly dissolving hydrogen gas in organ preservation solutions by using a canister containing hydrogen-absorbing alloy. The efficacy of hydrogen-containing organ preservation solution created by this method was tested in a miniature pig model of kidney transplantation from donors with circulatory arrest. The time required for dissolution of hydrogen gas was only 2-3 minutes. When hydrogen gas was infused into a bag containing cold ETK organ preservation solution at a pressure of 0.06 MPa and the bag was subsequently opened to the air, the dissolved hydrogen concentration remained at 1.0 mg/L or more for 4 hours. After warm ischemic injury was induced by circulatory arrest for 30 minutes, donor kidneys were harvested and perfused for 5 minutes with hydrogen-containing cold ETK solution or hydrogen-free cold ETK solution. The perfusion rate was faster from the initial stage with hydrogen-containing cold ETK solution than with hydrogen-free ETK solution. After storage of the kidney in hydrogen-free preservation solution for 1 hour before transplantation, no urine production was observed and blood flow was not detected in the transplanted kidney at sacrifice on postoperative day 6. In contrast, after storage in hydrogen-containing preservation solution for either 1 or 4 hours, urine was detected in the bladder and blood flow was confirmed in the transplanted kidney. This method of dissolving hydrogen gas in organ preservation solution is a practical technique for potentially converting damaged organs to transplantable organs that can be used safely in any clinical setting where organs are removed from donors.
Highlights
Transplantation of marginal organs from donors after circulatory arrest is an important option to reduce the waiting period for recipients
We investigated a practical technique for rapidly dissolving hydrogen gas in organ preservation solutions by using a canister containing hydrogen-absorbing alloy
When hydrogen gas was infused into a bag containing cold extracellular-type trehalose-containing Kyoto (ETK) organ preservation solution at a pressure of 0.06 MPa and the bag was subsequently opened to the air, the dissolved hydrogen concentration remained at 1.0 mg/L or more for 4 hours
Summary
Transplantation of marginal organs from donors after circulatory arrest is an important option to reduce the waiting period for recipients. It is possible to expose the excised organ to hydrogen gas ex vivo without the donor and/or recipient inhaling the gas, and various methods have been devised to dissolve hydrogen gas in organ preservation solutions, including use of a hydrogen gas cylinder [6], electrolysis [18, 20, 21, 22], or a hydrogen-generating agent [17]. These methods require bulky equipment and dangerous high-pressure cylinders with strict regulations for handling, resulting in the need to expend considerable time and effort for preparation. A simple technique for rapidly dissolving hydrogen gas in organ preservation solutions is required
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