Irreversible electroporation of the liver: Is there a safe limit to the ablation volume?

Sánchez-Velázquez, P. ; Castellví, Q. ; Villanueva, A. ; Quesada, R. ; Pañella, C. ; Cáceres, M. ; Dorcaratto, D. ; Andaluz, A. ; Moll, X. ; Trujillo, M. ; Burdió, J.M. (Universidad de Zaragoza) ; Berjano, E. ; Grande, L. ; Ivorra, A. ; Burdió, F.

Resumen: 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 strength (1000 V/cm, 2000 V/cm) and whether or not they received anti-hyperkalemia therapy. Early mortality (less than 24 hours post-IRE) in the 2000 V/cm group was observed and revealed considerably higher mean potassium levels. In contrast, the animals subjected to a 2000 V/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 1000 V/cm survived longer than those given 2000 V/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.

Idioma: Inglés

DOI: 10.1038/srep23781

Año: 2016

Publicado en: SCIENTIFIC REPORTS 6 (2016), 23781 [7 pp]
ISSN: 2045-2322

Factor impacto JCR: 4.259 (2016)

Categ. JCR: MULTIDISCIPLINARY SCIENCES rank: 10 / 63 = 0.159 (2016) - Q1 - T1

Factor impacto SCIMAGO: 1.691 - Multidisciplinary (Q1)

Financiación: info:eu-repo/grantAgreement/ES/MINECO/TEC2010-17285
Financiación: info:eu-repo/grantAgreement/ES/MINECO/TEC2011-27133-C02
Financiación: info:eu-repo/grantAgreement/ES/MINECO/TEC2014-52383-C3-1-R
Financiación: info:eu-repo/grantAgreement/ES/MINECO/TEC2014-52383-C3-2-R
Financiación: info:eu-repo/grantAgreement/ES/MINECO/TEC2014-52383-C3-3-R

Tipo y forma: Artículo (Versión definitiva)

Área (Departamento): Área Tecnología Electrónica (Dpto. Ingeniería Electrón.Com.)