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Sci Rep. 2016 Apr 1;6:23781. doi: 10.1038/srep23781.

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

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Department of Surgery, Hospital del Mar, Hospital del Mar Medical Research Institute (IMIM), Passeig Marítim 25-29, 08003, Barcelona, Spain.
Department of Information and Communication Technologies, Universitat Pompeu Fabra, Carrer Roc Boronat 138, 08018, Barcelona, Spain.
Translational Research Laboratory, Catalan Institute of Oncology (ICO), Bellvitge Biomedical Research Institute (IDIBELL), Av. de la Granvia de l'Hospitalet, 199-203, 08908 L'Hospitalet de Llobregat, Barcelona, Spain.
Department of Animal Medicine and Surgery, Faculty of Veterinary Medicine, Autonomous University of Barcelona (U.A.B), Plaza Cívica, s/n, 08193 Bellaterra, Barcelona, Spain.
Electronic Engineering Department, Universitat Politècnica de Valencia, Camino de Vera, 46022 Valencia, Spain.
Department of Electric Engineering and Communications, University of Zaragoza, Pedro Cerbuna, 12, 50018 Zaragoza, Spain.


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.

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