Ablative Liver Partition and Portal Vein Embolization: Proof-of-Concept Testing in a Rabbit Model |
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Authors: | Ron C Gaba James T Bui Rajyasree Emmadi Janesh Lakhoo |
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Institution: | 1. Department of Radiology, Division of Interventional Radiology, University of Illinois Hospital & Health Sciences System, 1740 W. Taylor St., MC 931, Chicago, IL 60612;2. Department of Pathology, University of Illinois Hospital & Health Sciences System, 1740 W. Taylor St., MC 931, Chicago, IL 60612;3. College of Medicine, University of Illinois Hospital & Health Sciences System, 1740 W. Taylor St., MC 931, Chicago, IL 60612 |
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Abstract: | PurposeTo test the hypothesis that a modified approach to portal vein embolization (PVE)—termed ablative liver partition (ALP) and PVE (ALP-PVE)—is feasible and results in greater future liver remnant (FLR) growth compared with PVE alone in a rabbit model.Materials and MethodsEighteen rabbits (median weight, 2.7 kg) underwent PVE (n = 9) or ALP-PVE (n = 9). PVE to cranial liver lobes was performed with 100–300-μm microspheres and metallic coils; the caudal lobe was spared as the FLR. In the ALP-PVE cohort, a liver partition between cranial and caudal lobes was created by using microwave ablation (40 W, 1 min). Animals were euthanized and livers were harvested on postprocedure day 7. Caudal and cranial liver lobes were weighed after 4 weeks of oven drying. Ki-67 immunohistochemistry was used to quantify liver mitotic index. ALP-PVE feasibility was determined based on procedure technical success. Standardized FLR (sFLR; ie, FLR divided by whole liver weight) and mitotic index were compared between PVE and ALP-PVE groups by two-tailed independent-samples Mann–Whitney U test.ResultsOne PVE-group rabbit died during anesthesia induction and was excluded from technical success calculation. Eight of 8 (100%) and 8 of 9 rabbits (89%) underwent technically successful PVE and ALP-PVE, respectively. There was no difference in sex or weight distribution between groups. sFLR (0.32 vs 0.29; P = .022) and mitotic index (17.5% vs 6.2%; P = .051) were higher in ALP-PVE vs PVE caudal lobes when the first “learning-curve” case from each group was excluded.ConclusionsALP-PVE is feasible and may stimulate greater FLR growth compared with PVE in a rabbit model. |
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Keywords: | ALP ablative liver partition ALPPS associated liver partition and portal vein ligation FLR future liver remnant IHC immunohistochemistry PV portal vein PVE portal vein embolization sFLR standardized future liver remnant |
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