Clara Pañella Vilamunt
Our group is studying the effect of hypersaline infusion through de portal vein in order to focus electroporation only in scattered tumor tissue. The electroporation is a non-thermic ablative technique that uses high voltage electric fields to produce a cellular cytoskeleton disruption. These cell membrane nanopores, a consequence of high voltages, involve increase in the permeability itself, electrolyte imbalances and therefore, massive apoptosis. EP is irreversible when the cell membrane is non-repairable anymore and it occurs with voltages of high intensity (680V/cm is the threshold of irreversibility identified by the liver tissue).
Taking to account these preconditions, our research group raises a new hypothesis on the use of irreversible electroporation (IRE). We would change the environment conditions of IRE to be focused only in the tumor tissue, respecting healthy tissue. This hypothesis might be feasible by using a hypersaline infusion (HI, NaCl 20%) through the portal vein. To understand this, we must remember hepatic vascular anatomy with blood supply of 70% from the portal vein and the rest through the hepatic artery. By contrast, the hepatic artery is the only blood supply for hepatic tumors. The HI gets exclusively in healthy liver tissue and its electrical conductivity increases. When applying IRE in liver surface, the electric field will be significantly higher in scattered tumor nodules than in healthy tissue, providing focused ablation.
The aim of the study is to evaluate feasibility and safety of selectively increasing the conductivity of healthy liver tissue by means of portal HI, which creates a therapeutic window with a differential conductivity between healthy and tumor tissue.
This ambitious approach could be a new therapeutic tool to treat simultaneously scattered nodules and sparing the healthy tissue.