Saudi Journal of Gastroenterology
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ORIGINAL ARTICLE
Year : 2011  |  Volume : 17  |  Issue : 5  |  Page : 335-342

Electrochemical treatment: An investigation of dose-response relationships using an isolated liver perfusion model


1 Department of Surgery, University of Luebeck Medical School, Ratzeburger Allee 160, Luebeck, Germany
2 Institute of Pathology, University of Luebeck Medical School, Ratzeburger Allee 160, Luebeck, Germany
3 Department of Radiology, University of Luebeck Medical School, Ratzeburger Allee 160, Luebeck, Germany

Correspondence Address:
Ralf Czymek
Department of Surgery, University of Luebeck Medical School, Ratzeburger Allee 160, D-23538 Luebeck
Germany
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1319-3767.84491

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Background/Aim: Ablative techniques such as radiofrequency ablation or non-thermal electrochemical treatment (ECT) are used to manage unresectable liver metastases. Although ECT is not affected by the cooling effect from adjacent vessels, there is a paucity of data available on ECT. Materials and Methods: We used porcine livers to establish an organ model with portal venous and hepatic arterial blood flow for a standardized analysis of the relationship between dose (electric charge) and response (volume of necrosis). Results: This model allowed us to study pressure-controlled perfusion of portal venous and hepatic arterial circulation in the absence of a capillary leak. A specially designed guiding template helped us place platinum electrodes at reproducible locations. With two electrodes, there was a linear relationship between charges of no more than 200 C and necrosis. The relationship was logarithmic at charges of 400-600 C. Larger electrode spacing led to a significant increase in necrosis. We measured pH values of 0.9 (range: 0.6-1.3) at the anode and 12.6 (range: 11.6-13.4) at the cathode. Conclusions: Using a perfusion model, we established an experimental design that allowed us to study ECT in the liver of large animals without experiments on living animals. An electrode template helped us improve the standardized analysis of dose-response relationships. ECT created reproducible and sharply demarcated areas of necrosis, the size of which depended on the charge delivered as well as on the number and spacing of electrodes. Doses higher than 600 C require longer treatment times but do not increase the area of necrosis (logarithmic dose-response relationship).


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