Donor Heart Preservation with Hydrogen Sulfide: A Systematic Review and Meta-Analysis

Imran A Ertugrul, Vincent van Suylen, Kevin Damman, Marie-Sophie L Y de Koning, Harry van Goor*, Michiel E Erasmus

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

10 Citations (Scopus)
103 Downloads (Pure)


Preclinical studies have shown that postconditioning with hydrogen sulfide (H2S) exerts cardioprotective effects against myocardial ischemia-reperfusion injury (IRI). The aim of this study was to appraise the current evidence of the cardioprotective effects of H2S against IRI in order to explore the future implementation of H2S in clinical cardiac transplantation. The current literature on H2S postconditioning in the setting of global myocardial ischemia was systematically reviewed and analyzed, performing meta-analyses. A literature search of the electronic databases Medline, Embase and Cinahl identified 1835 studies that were subjected to our pre-defined inclusion criteria. Sixteen studies were considered eligible for inclusion. Postconditioning with H2S showed significant robust effects with regard to limiting infarct size (standardized mean difference (SMD) = -4.12, 95% CI [-5.53--2.71], p < 0.00001). Furthermore, H2S postconditioning consistently resulted in a significantly lower release of cardiac injury markers, lower levels of oxidative stress and improved cardiac function. Postconditioning with slow-releasing H2S donors offers a valuable opportunity for novel therapies within cardiac preservation for transplantation. Before clinical implication, studies evaluating the long-term effects of H2S treatment and effects of H2S treatment in large animal studies are warranted.

Original languageEnglish
Article number5737
Number of pages15
JournalInternational Journal of Molecular Sciences
Issue number11
Publication statusPublished - 27-May-2021


  • Animals
  • Biomarkers
  • Cryopreservation/methods
  • Heart
  • Heart Function Tests
  • Heart Transplantation/methods
  • Humans
  • Hydrogen Sulfide/pharmacology
  • Ischemic Postconditioning
  • Myocardial Reperfusion Injury/diagnosis
  • Organ Preservation/methods
  • Organ Preservation Solutions
  • Oxidative Stress/drug effects
  • Risk Factors
  • Tissue Donors

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