title: Systematic reaction to electrolytic treatment of pig livers in vivo.
abstract: BACKGROUND
  Only a minority of secondary liver tumours are amenable to segmental resection and as a result, considerable research has been focused on developing ablative methods to destroy liver metastases. Many of these methods are limited by the development of a systemic inflammatory response mediated by cytokines such as interleukin-8 (IL-8) and tumour necrosis factor alpha (TNF-alpha). The aim of the present study was to determine if a systemic reaction occurred following electrolytic treatment of pig livers in vivo, by measuring biochemical indices of liver function and cytokines such as IL-8 and TNF-alpha.
  
  
  METHODS
  Seventeen white domestic pigs were subjected to varying electrolytic doses ranging from 100 C to 800 C. Blood samples were taken at hourly intervals before, during and after electrolysis. Blood parameters measured included markers of liver enzyme activity; albumin, alkaline phosphatase, gammaglutaryl transferase and aspartate transaminase. Cytokine response to electrolysis was measured using enzyme-linked immunosorbent assays for IL-8 and TNF-alpha.
  
  
  RESULTS
  Aspartate transaminase levels showed a clear and progressive rise post-electrolysis peaking at 2 h post-procedure. IL-8 and TNF-alpha levels showed only very mild variation with no significant response to electrolysis. This lack of association was borne out regardless of the electrolytic dose administered.
  
  
  CONCLUSIONS
  Electrolysis is not accompanied by a significant systemic inflammatory response, reducing the risk of systemic inflammatory response, acute respiratory distress syndrome and other immune response mediated end-organ damage. Follow-up studies are needed in human trials.
authors.affiliation: Department of Hepatobiliary Surgery, Leicester General Hospital, Leicester, Leicestershire, England, UK.
authors.forename: David
authors.initials: D
authors.lastname: Berry
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Garcea
authors.forename: Chillton
authors.initials: C
authors.lastname: Chong
authors.forename: Eric
authors.initials: E
authors.lastname: Silman
authors.forename: Guy
authors.initials: G
authors.lastname: Finch
authors.forename: Ashley
authors.initials: A
authors.lastname: Dennison
authors.forename: Guy J
authors.initials: GJ
authors.lastname: Maddern
mesh_terms: D000818:Animals; D015415:Biomarkers / Q000097:blood*; D004572:Electrolysis; D004598:Electrosurgery; D005260:Female; D007249:Inflammation / Q000097:blood; D016209:Interleukin-8 / Q000097:blood; D008099:Liver / Q000601:surgery*; D013552:Swine; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis
chemical_list: D015415:Biomarkers; D016209:Interleukin-8; D014409:Tumor Necrosis Factor-alpha