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. 2011 Mar;13(3):168-73.
doi: 10.1111/j.1477-2574.2010.00261.x. Epub 2011 Jan 25.

Irreversible electroporation of the liver and liver hilum in swine

Kevin P Charpentier  1 , Farrah Wolf, Lelia Noble, Brody Winn, Murray Resnick, Damian E Dupuy
Affiliations

Irreversible electroporation of the liver and liver hilum in swine

Kevin P Charpentier et al. HPB (Oxford). 2011 Mar.

Abstract

Background: Irreversible electroporation (IRE) is a novel, non-thermal form of ablation. We studied the safety and efficacy of IRE for the ablation of liver tissue around the liver hilum. We also studied the ability of triphenyltetrazolium chloride staining (TTC) to predict the zone of ablation after IRE.

Methods: Eight swine underwent 20 ablations of the liver and liver hilum. Two monopolar probes were positioned 2 cm apart. IRE was performed using 90 pulses of 2500-3000 V/cm. IRE treatments were performed from 15 min to 14 days (n= 4) before sacrifice.

Results: All animals survived. No major complications were encountered. Ablation width ranged from 2.27 to 4.45 cm and ablation height ranged from 1.5 to 1.8 cm. TTC staining demonstrated the zone of ablation in all animals. Hepatocyte necrosis occurs immediately adjacent to large central veins without evidence of heat sink. Bile ducts, portal veins and hepatic arteries appear to be more resistant to the effects of IRE.

Conclusions: IRE appears to be safe and effective for liver tissue ablation in the liver hilum. The portal structures appear more resistant to the effects of IRE. TTC staining can predict the zone of IRE ablation as early as 15 min after treatment.

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Figures

Figure 1
Figure 1
Liver irreversible electroporation (IRE) ablation using two monopolar probes, spaced 2 cm apart with a 2-cm exposure. Ablation was performed using 3000 V/cm and was repeated with reverse polarity. The tissue was harvested 2 h after IRE ablation. (a) Shows fresh tissue and (b) shows the tissue after fixation with triphenyltetrazolium chloride. The area of necrosis extends to the wall of the central vein (arrow) with preservation of the vein and no evidence of heat sink
Figure 2
Figure 2
A 20× photomicrograph depicts haemorrhagic necrosis of the hepatocyte lobules after irreversible electroporation (IRE) ablation. Portal structures are more preserved. Preserved bile ducts are highlighted by the narrow arrows and the preserved portal vein is highlighted by the wide arrow
Figure 3
Figure 3
Liver irreversible electroporation (IRE) ablation with monopolar electrodes positioned on either side of the portal triad, 2 cm apart in the liver hilum. Ablation was performed with 3000 V/cm and reverse polarity. The zone of ablation is larger and more irregular when compared with intra-hepatic liver IRE ablations (3a). Hepatocyte necrosis occurs immediately up to the fibrous capsule of the portal triad with histological preservation of the bile duct (BD), hepatic artery (HA) and portal vein (PV) (3b; 4× photomicrograph)
Figure 4
Figure 4
Triphenyltetrazolium chloride (TTC) staining can predict the zone of ablation after irreversible electroporation (IRE). TTC fixed liver tissue is shown 15 min (4a), 30 min (4b) and 1 h (4c) after IRE. The surrounding, viable liver tissue retains the red, triphenyltetrazolium chloride dye while dye washes out of the necrotic, ablated liver over time. The ablation zone is predictable at 15 min and becomes more apparent by 1 h. The zone of ablation is highlighted by the dotted white line
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