RESUMEN
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. CONCLUSION: 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.