Morphological and biochemical effects of intrahepatic alcohol injection in the rabbit

Abstract

The local and systemic effects, as well as the repair mechanisms, of sterile absolute ethyl alcohol injection were evaluated at a range of doses (0.1-2.0 mL/kg body weight) in rabbit liver in order to confirm the feasibility and safety of local treatment of tumours in man. Saline injection was used in the control animals. The animals were killed at varying intervals (range: 1-30 days after injection), and the liver was studied by gross and microscopic examination. The ethyl alcohol injection was well tolerated and did not induce significant systemic side-effects. All doses could induce necrosis and none proved to be lethal. The alcohol injection produced an area of coagulation necrosis, the size of which appeared to be dose-related, and which was surrounded by granulation tissue, gradually repairing the necrotic lesion; the adjacent tissue was intact, or had signs of mild steatosis. However, at higher doses (1.0 and 2.0 mL/kg bodyweight), necrotic lesions were observed in the liver both near and remote from the site of injection. Fine needle percutaneous alcohol injection is effective in producing necrotic lesions which appear to be dose-related; at higher doses, however, an unpredictable intrahepatic diffusion may occur.

Survival benefit of patients with inoperable hepatocellular carcinoma treated by a combination of transarterial chemoembolization and percutaneous ethanol injection—a single-center analysis including 132 patients

“…We used 2 locoregional, non-surgical therapeutic strategies: PEI and TACE. PEI is based on the anti-tumor effects of ethanol, which dehydrates and coagulates tumorous tissue on contact and causes vascular occlusion (Festi et al, 1990). Under optimal conditions (1 lesion, Յ3 cm .…”

Fatal liver necrosis following percutaneous ethanol injection for hepatocellular carcinoma

“…Necrotic liver areas near tumors treated with clinical PEIT have been reported [4]. In an experiment with rabbits [5], high doses of ethanol (1-2 ml/kg body weight) induced necrotic lesions in the liver both near and remote from the site of injections due to an unpredictable intrahepatic diffusion. In another experimental work, an uncontrolled spread of ethanol occurred twice, when 48 ethanol doses of 0.5-2.0 ml were injected in the livers of normal pigs [6].…”

Tissue Chemoablation

“…[1][2][3][4][5][6] Alcohol diffuses into cells, producing immediate dehydration, membrane lysis, and protein denaturation, followed by fibrosis and small-vessel occlusion/thrombosis. The combination of these factors leads to coagulation necrosis.…”