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Early animal models suggest that oral H₂-enriched solutions reduce proteinuria, histopathological damage, and oxidative markers.22 Further innovations in organ preservation indicate that H₂-containing solutions may improve graft outcomes compared to conventional fluids, diminishing tubular injury, apoptosis, and oxidative stress.38,41,48,49 However, some studies find minimal benefit from H₂ alone, highlighting the need for optimized delivery or combination strategies (such as with carbon monoxide).48,50,51 Preclinical data generally point to a favorable safety profile, yet certain ex vivo large-animal studies yield inconsistent results, suggesting that dosing refinements and synergistic therapies warrant further exploration.48,49,50 Additionally, few clinical trials focus on graft survival or long-term function as primary endpoints, underscoring the importance of investigating H₂ impact on chronic rejection, infection rates, and immunosuppression requirements

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