733 IRREVERSIBLE ELECTROPORATION (IRE): A NOVEL METHOD FOR RENAL TISSUE ABLATION

Abstract

You have accessJournal of UrologyTechnology & Instruments: Robotics/Laparoscopy/Ureteroscopy I1 Apr 2010733 IRREVERSIBLE ELECTROPORATION (IRE): A NOVEL METHOD FOR RENAL TISSUE ABLATION Chad R. Tracy, Wareef Kabbani, and Jeffrey A. Cadeddu Chad R. TracyChad R. Tracy Iowa City, IA More articles by this author , Wareef KabbaniWareef Kabbani Dallas, TX More articles by this author , and Jeffrey A. CadedduJeffrey A. Cadeddu Dallas, TX More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2010.02.1221AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Irreversible electroporation (IRE) creates nano-scale pores within cellular membranes as a consequence of an electric field across the cell, resulting in athermal cellular death. Previous liver experiments demonstrated precise areas of cellular death, with relative sparing of vascular and biliary structures. We report the initial results using this technology in porcine kidneys. METHODS Eight female Yorkshire pigs underwent a series of laparoscopic ablations using either monopolar or bipolar IRE (Angiodynamics, Queensbury, NY). Animals were sacrificed between 10 minutes and 14 days following ablation and kidneys were harvested for gross and histologic analysis, including NADH staining for cellular viability. RESULTS Twenty-four total ablations were performed and all animals lived until sacrifice without complications. Initial gross lesions were diffusely hemorrhagic, decreasing progressively in size (30-40%) to small white scars over the 14-day period. Immediately following IRE, ablated tissue was characterized by diffuse tubular desquamation, eosinophilia, and nuclear pyknosis, with absence of cellular viability by NADH. By 7 days, there was diffuse cellular necrosis with early peripheral granulation changes, and by 14 days there was marked tissue granulation, chronic inflammation, and dystrophic calcification with early fibrosis and cellular contraction. Initial patchy urothelial injury and ulceration demonstrated signs of repair and viability by 14 days. CONCLUSIONS Renal IRE in the porcine kidney leads to predictable histologic changes characteristic of cellular death within 1 hour of ablation, with relative urothelial sparing. Further animal studies are warranted to determine safety and efficacy of this novel ablation technology. © 2010 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 183Issue 4SApril 2010Page: e286-e287 Advertisement Copyright & Permissions© 2010 by American Urological Association Education and Research, Inc.MetricsAuthor Information Chad R. Tracy Iowa City, IA More articles by this author Wareef Kabbani Dallas, TX More articles by this author Jeffrey A. Cadeddu Dallas, TX More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...