Use this URL to cite or link to this record in EThOS: http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.617625
Title: The evaluation of different techniques of hepatic ablation in an ex-vivo perfused porcine liver model
Author: Gravante, Gianpiero
ISNI:       0000 0004 5351 2966
Awarding Body: University of Leicester
Current Institution: University of Leicester
Date of Award: 2014
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Abstract:
Background: Electrolytic ablation (EA) is a technique of liver ablation that produces extreme pH changes in the local microenvironment. An ex-vivo perfused liver model compared EA vs. radiofrequency ablation (RFA) and analysed biochemical, immunological and histologic parameters. Methods: Seventeen pigs were perfused extracorporeally with normothermic autologous blood, five of which underwent RFA and five EA after one hour from reperfusion. Arterial, venous blood samples and histologic specimen were collected hourly and analysed for 1) arterial blood gases content, 2) biochemical parameters, 3) cytokines, 4) and tissue modifications. Results: No significant differences were registered among techniques for biochemical and immunologic parameters investigated. EA created a smaller transitional zone of ablation compared to RFA and histologically a particular pattern of changes in which the coagulative necrosis and hemorrhages affected mainly the peripheral area of the lobule, while the sinusoidal dilatations the centrilobular area. No significant changes were found for the apoptosis and the regeneration activity. Conclusions: Although results of the histological changes are interesting, the technical complexity of the ex-vivo model increased the number of parameters to monitor, especially concerning the liver viability and the administration of external substances to maintain a physiologic environment. Furthermore, the high portal vein pressures used and long warm ischemia times registered could have biased results. For the purpose of this study an in-vivo model would have been more appropriate.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (M.D.) Qualification Level: Doctoral
EThOS ID: uk.bl.ethos.617625  DOI: Not available
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