Inhalation of molecular hydrogen prevents ischemia-reperfusion liver damage during major liver resection
Malý O, Zajak J, Hyšpler R, Turek Z, Astapenko D, Jun D, Váňová N, Kohout A, Radochová V, Kotek J, Páral J. · Annals of Translational Medicine. 2019;7(23):774.
Study at a glance
Preclinical
Healthy domestic pigs undergoing a liver-resection model with 120 minutes of warm ischemia followed by 120 minutes of reperfusion.
H₂ was added from induction of general anesthesia through surgery and the end of the experiment in a closed-circuit anesthesia machine. · 2% H₂, 40% O₂ and 58% N₂ at a reported total fresh-gas flow of 1 L/min, with isoflurane used for anesthesia.
From anesthesia induction through 120 minutes of warm liver ischemia and 120 minutes of reperfusion.
Liver histology scores were lower with H₂. Most biochemical outcomes—including ALT, AST, ALP, LD, lactate and creatine-kinase BB—and the tested plasma and liver oxidative-damage markers did not differ significantly; gamma-glutamyl-transferase was the notable significant biochemical finding.
Only 12 pigs, acute terminal experiment, surrogate histological and biochemical endpoints, no postoperative recovery or clinical outcome and multiple comparisons. The authors' language is stronger than the mixed result set. The Czech Ministry of Defence funded the work; the authors declared no conflicts of interest.
What kind of evidence is this?
Preclinical
Randomized controlled large-animal surgical experiment
Liver health
Inhaled H₂
Information not yet classified
Some editorial classification fields are still pending. The source-reported outcomes and result are shown below; Hydrogenology does not infer a positive or negative signal from prose automatically.
Methods
Healthy domestic pigs undergoing a liver-resection model with 120 minutes of warm ischemia followed by 120 minutes of reperfusion.
12 pigs: inhaled-H₂ group n=6 and control anesthesia group n=6.
From anesthesia induction through 120 minutes of warm liver ischemia and 120 minutes of reperfusion.
H₂ was added from induction of general anesthesia through surgery and the end of the experiment in a closed-circuit anesthesia machine.
H₂ alone added to an oxygen/nitrogen anesthesia carrier — not Brown's gas.
2% H₂, 40% O₂ and 58% N₂ at a reported total fresh-gas flow of 1 L/min, with isoflurane used for anesthesia.
20 mL/min H₂, calculated from 1,000 mL/min total flow × 2% H₂.
40% O₂; 400 mL/min O₂, calculated from 1,000 mL/min × 40%. The remaining carrier was 580 mL/min N₂, apart from anesthetic vapor.
The same surgery and general-anesthesia protocol without added H₂; the control carrier contained 40% O₂ and 58–60% N₂.
Outcomes and reported result
Liver histology and Suzuki injury score, ALT, AST, ALP, gamma-glutamyl-transferase, lactate dehydrogenase, lactate, creatine-kinase BB and plasma/tissue oxidative-damage markers.
Liver histology scores were lower with H₂. Most biochemical outcomes—including ALT, AST, ALP, LD, lactate and creatine-kinase BB—and the tested plasma and liver oxidative-damage markers did not differ significantly; gamma-glutamyl-transferase was the notable significant biochemical finding.
The complete free publisher article, randomization, anesthesia mixture, total flow, surgical timing, positive and null results, funding and conflict statement were checked.
A reported association, difference or mechanism is not automatically a clinical benefit.
Limitations and applicability
Only 12 pigs, acute terminal experiment, surrogate histological and biochemical endpoints, no postoperative recovery or clinical outcome and multiple comparisons. The authors' language is stronger than the mixed result set. The Czech Ministry of Defence funded the work; the authors declared no conflicts of interest.
Preclinical liver ischemia-reperfusion model in pigs; it does not establish efficacy or safety during human liver surgery.
No single-study GRADE certainty rating is assigned. Read how records and evidence assessments are prepared.
Sources and record status
PMID: 32042790 · DOI: 10.21037/atm.2019.11.43
Free publisher full article and PubMed Central copy.
Annals of Translational Medicine publisher article, PubMed Central copy and PubMed metadata; full-text extraction checked 9 August 2026.
10 August 2026
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