Title:
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Irreversible electroporation of the liver: is there a safe limit to the ablation volume?
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Author:
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Sánchez-Velázquez, Joan; Castellví Fernández, Quim; Villanueva, Alberto; Quesada Diez, Rita; Pañella-Vilamú, Clara; Cáceres Aguilar, Mario; Dorcaratto, Dimitri; Andaluz, Anna; Moll, Xavier; Trujillo Guillén, Macarena; Burdío, José Miguel; Berjano, Enrique J.; Grande Posa, Luís; Ivorra Cano, Antoni, 1974-; Burdío Pinilla, Fernando
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Abstract:
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Irreversible electroporation is a fast-growing liver ablation technique. Although safety has been well documented in small ablations, our aim is to assess its safety and feasibility when a large portion of liver is ablated. Eighty-seven mice were subjected to high voltage pulses directly delivered across parallel plate electrodes comprising around 40% of mouse liver. One group consisted in 55 athymic-nude, in which a tumor from the KM12C cell line was grown and the other thirty-two C57-Bl6 non-tumoral mice. Both groups were subsequently divided into subsets according to the delivered field /nstrength (1000V/cm, 2000V/cm) and whether or not they received anti-hyperkalemia therapy. Early mortality (less than 24hours post-IRE) in the 2000V/cm group was observed and revealed considerably higher mean potassium levels. In contrast, the animals subjected to a 2000V/cm field treated with the anti-hyperkalemia therapy had higher survival rates (OR=0.1, 95%CI=0.02–0.32, p<0.001). Early mortality also depended on the electric field magnitude of the IRE protocol, as mice given 1000V/cm survived longer than those given 2000V/cm (OR=4.7, 95%CI=1.8–11.8, p=0.001). Our findings suggest that ionic disturbances, mainly due to potassium alterations, should be warned and envisioned when large volume ablations are performed by IRE. |
Abstract:
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This research was supported by the Spanish “Plan Estatal de Investigación, Desarrollo e Innovación Orientada/na los Retos de la Sociedad” under Grant TEC2014–52383-C3 (TEC2014-52383-C3-1-R, TEC2014-52383-C3-/n2-R, and TEC2014-52383-C3-3-R), and by the Spanish “Plan Nacional de I + D + i del Ministerio de Ciencia e/nInnovación” under Grants TEC2011-27133-C02 and TEC2010-17285. |
Rights:
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http://creativecommons.org/licenses/by/4.0/ |
Document type:
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Article Article - Published version |
Published by:
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Nature Publishing Group
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