Systematic reaction to electrolytic treatment of pig livers in vivo.
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.
Berry
David
D
Department of Hepatobiliary Surgery, Leicester General Hospital, Leicester, Leicestershire, England, UK.
Garcea
Giuseppe
G
Chong
Chillton
C
Silman
Eric
E
Finch
Guy
G
Dennison
Ashley
A
Maddern
Guy J
GJ
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
D015415:Biomarkers; D016209:Interleukin-8; D014409:Tumor Necrosis Factor-alpha