TAIPEI, TAIWAN (UroToday.com) - Introduction and Objectives: Irreversible electroporation (IRE) uses short pulses of DC electric current to create irreversible pores in the cell membrane, thereby causing cell death. We conducted a prospective trial to compare kidney function and pathological changes post-IRE in a solitary kidney porcine model to partial nephrectomy and radiofrequency ablation (RFA).
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Methods: Fifteen domesticated pigs were randomized into 3 equal groups. All pigs underwent laparoscopic nephrectomy to create the condition of a solitary kidney. On the remaining kidney either IRE, partial nephrectomy or RFA was performed on the lower third. Serum creatinine (SCr) was taken at baseline, 24 hrs, 3, 7, 14, and 28 days postoperatively. Repeated- measures ANOVA and Student’s t-test were used to compare change in mean SCr from baseline. Acute and chronic histological changes were analyzed and cellular viability was assessed using NADH staining in the IRE porcine model.
Results: In all, 10 ablations (5 IRE, 5 RFA) and 5 partial nephrectomies of the lower third of a solitary kidney were performed. All pigs survived without complications. The type of procedure did not affect change in baseline SCr significantly (p = 0.14). The change in mean SCr from baseline was not significantly different across time for any of the three groups (p > 0.05). NADH stain showed absence of viability in the necrotic areas immediately, at days 14 and 28 and viable tissue in the areas with reparative changes.
Conclusions: IRE in the porcine kidney shows comparable changes in renal function with time as compared to other treatments. Further studies are warranted to study efficacy.
Source of Funding: None
|Listen to an interview with Monica S.C. Morgan, one of the authors of this study.|
Presented by Monica S.C. Morgan,1 Asim Ozayar,1 Elena Lucas,2 Justin I. Friedlander,1 Nabeel Shakir,1 Neil Gupta,1 and Jeffrey A. Cadeddu1 at the 32nd World Congress of Endourology & SWL - September 3 - 7, 2014 - Taipei, Taiwan
1University of Texas Southwestern, Department of Urology, Dallas, TX USA
2University of Texas Southwestern, Department of Pathology, Dallas, TX USA