肾移植通俗的说法又叫换肾，就是将健康者的肾脏移植给有肾脏病变并丧失肾脏功能的患者。人体有左右两个肾脏，通常一个肾脏可以支持正常的代谢需求，当双侧肾脏功能均丧失时，肾移植是最理想的治疗方法，故凡是慢性肾功能不全发展至终末期，均可用肾移植治疗。肾移植因其供肾来源不同分为自体肾移植、同种肾移植和异种肾移植，习惯把同种肾移植简称为肾移植。其他两种肾移植则冠以“自体”或“异种”肾移植以资区别。

肾移植可以发生无肾功能、肾移植术后发生早期肾功能不全和肾移植术后发生晚期肾功能减退，总之移植后肾功能不全是肾脏移植后的重要并发症，是该领域非常关注的问题。

随着免疫抑制药物的发展，肾移植急性排斥反应基本上都可以得到控制，但慢性移植功能不全尚无明确有效的治疗药物和方法，慢性移植肾病是导致移植肾晚期功能丧失的最主要原因。

慢性移植肾病的发病机制目前比较公认的观点是：本病是由异种抗原依赖的免疫因素（如急性排斥反应、免疫抑制剂不足等）及非异种抗原依赖的因素（如延长的冷缺血时间、供体年龄、受体脂代谢异常、高血压、糖尿病或糖耐量异常、移植后6～12月间肾功能受损、巨细胞病毒感染等）导致的移植肾功能持续恶化和发展。本研究作者曾经在Fisher344－Lewis大鼠慢性移植肾病模型发现：成年鼠间肾移植的慢性移植肾病显著比幼年鼠间肾移植的慢性移植肾病严重。

该研究通过动物肾脏移植模型，持续给动物饮用氢水150天，最后比较了不同组的肾脏功能、死亡率、炎症因子和MAPK细胞信号分子系统，结果证明，长时间饮用含氢水可以预防慢性移植肾病的发生，研究给临床上治疗移植后肾脏功能不全带来了新希望。这也是氢分子医学研究方面的又一力作。文章来自美国著名氢气医学研究小组匹兹堡大学器官移植中心Nakao小组。

不过本人学术好友Nakao教授，2012年日本福岛海啸后从美国已经返回日本工作，职业为急救科医生，氢气医学虽然仍然是他的科研内容，但已经比在美国少多了。

ORALADMINISTRATION OF HYDROGEN WATER PREVENTS CHRONIC ALLOGRAFTNEPHROPATHY IN RAT RENAL TRANSPLANTATION

Tissueinjury, induced by reactive oxygen species (ROS), contributes to thedevelopment of chronic allograft nephropathy (CAN; also known as interstitialfibrosis and tubuar atrophy with unknown etiology [IF/TA]) after renaltransplantation. Molecular hydrogen gas can act as a ROS scavenger. Wehypothesized that administration of hydrogen water (HW) would ameliorate CAN byscavenging ROS. Using a rat model of kidney transplantation, LEW rat allograftswere orthotopically transplanted into BN rat recipients that had undergonebilateral nephrectomy.

Molecularhydrogen was dissolved in water (>0.8 mM) and recipients were given eitherregular water (RW) or HW from day 0 to day 150, or death. RW-treated animalsexperienced a gradual decline in creatinine clearance, associated withproteinuria, which ultimately led to graft failure secondary to CAN. Incontrast, HW administration improved allograft function, slowed the

progressionof CAN, and improved overall survival. HW also reduced oxidant injury andinflammatory mediator production. Additionally, inflammatory signaling pathways(mitogen activated protein kinases) were less activated in renal allograftsfrom HW-treated rats compared to the RW-treated group. These data indicate thatorally administered HW is an effective antioxidant and anti-inflammatory agentthat can prevent CAN and improve survival in a model of rodent renaltransplantation. HW may be of therapeutic value in the setting oftransplantation.