Patterns of histological changes following hepatic electrolytic ablation in an ex-vivo perfused model.
Electrolytic ablation (EA) destroys the liver by releasing toxic radicles and producing modifications in the local pH without increasing the tissue temperature. We assessed the histological changes produced by EA using an ex-vivo perfused model. Five porcine livers were harvested, preserved in ice and reperfused for six hours in an extracorporeal circuit using autologous normothermic blood. One hour after reperfusion EA was performed and liver biopsies collected at the end of the experiments. The main necrotic zone consisted of coagulative necrosis, sinusoidal dilatation and haemorrhage with an unusual morphological pattern. The coagulative necrosis and haemorrhage affected mainly the peripheral area of the lobule with relative sparing of the area surrounding the centrilobular vein. Contrasting with this sinusoidal dilatation appeared to be more prominent in the centrilobular area. EA produces patterns of tissue destruction that have not been observed with the more commonly used thermal techniques. Further studies should obtain more information about the influence of adjacent biliary and vascular structures so that appropriate clinical trials can be designed.
Department of Hepatobiliary and Pancreatic Surgery, Leicester General Hospital, Leicester, UK. ggravante@hotmail.com
Gianpiero
G
Gravante
Seok Ling
SL
Ong
Kevin
K
West
Angus
A
McGregor
Guy J
GJ
Maddern
Matthew S
MS
Metcalfe
David M
DM
Lloyd
Ashley R
AR
Dennison
D000818:Animals; D004564:Electrocoagulation / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006651:Histocytochemistry; D008099:Liver / Q000473:pathology* / Q000528:radiation effects / Q000601:surgery*; D009336:Necrosis; D015424:Reperfusion; D013552:Swine