Perioperative Mitigation of Oxidative Stress with Molecular Hydrogen During Simulated Heart Transplantation in Pigs

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发表日期：

2024年

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Branislav Kura,
Barbara Szeiffova Bacova,
Miroslav Barancik,
Matus Sykora,
Ludmila Okruhlicova,
Narcisa Tribulova,
Roberto Bolli,
Barbora Kalocayova,
Tyler W. LeBaron,
Katarina Andelova,
Jan Slezak

摘要

Heart transplantation is now a routine method for severe heart failure treatment. It is critical to focus on preventing ischemia–reperfusion damage and mitigating oxidative stress to achieve successful outcomes. However, prolonged anesthesia, hyperoxia, and defibrillations contribute to an increase of ROS/RNS and disrupt the redox homeostasis, which poses a serious risk factor. Numerous publications have confirmed the remarkable antioxidant, anti-apoptotic, and anti-inflammatory properties of molecular hydrogen. In our simulated heart transplantation experiment, we demonstrate that administering 2% hydrogen gas during anesthesia and extracorporeal circulation (ECC) significantly alleviates oxidative stress-induced damage. This is evidenced by a significant decrease in markers of ischemia, lipid peroxidation, and inflammation. The restoration of the pumping activity in the implanted pig hearts showed improvement, with a reduced need for repeated defibrillations. The administration of H2 during graft collection and transplantation significantly enhances the function of the transplanted heart and the overall condition of the recipient. Hydrogen administered by conventional ventilators and ECC oxygenators represents an innovative therapy that can significantly improve current transplantation techniques.