title: Cell-Free and Concentrated Ascites Reinfusion Therapy for Decompensated Liver Cirrhosis.
abstract: Cell-free and concentrated ascites reinfusion therapy (CART) is expected to improve symptoms associated with refractory ascites of the decompensated liver cirrhosis patients. The aim of this study was to evaluate the safety and efficacy of the CART system performed on the decompensated liver cirrhosis patients. In this retrospective observational study, we evaluated 24 CART processes performed on 11 patients with decompensated liver cirrhosis. We evaluated the effectiveness and adverse events during CART procedures. The amounts of collected and concentrated ascites were 4491.7 ± 2222.8 mL (mean ± SD), respectively, and the concentration ratio was 22.4 ± 15.3 times, respectively. The amount of collected protein in ascites was 2.3 ± 0.5 g/dL, and concentration ratio of protein was 8.2 ± 9.4 times. Serum protein level was not significantly different between before and after CART sessions. Thus, CART allowed for the reduction of doses of albumin preparations (Alb) to be administered. CART has been reported to cause two adverse reactions: elevation of body temperature and decrease in blood pressure. In our study, decreased blood pressure was not observed even in patients with > 5 L of ascites drained. Although a transient elevation in body temperature was seen in only one patient, this febrile patient immediately returned to normal body temperature with the use of NSAIDs. In patients with refractory ascites of decompensated liver cirrhosis in whom complete cure cannot be expected, CART improves their QOL and, in terms of medical economy, allows for the reduction of doses of Alb. CART can be effectively applied as a palliative procedure for refractory ascites of decompensated liver cirrhosis patients.
authors: Department of Surgery, National Hospital Organization, Mito Medical Center, Ibaraki, Japan.|Department of Clinical Engineering, National Hospital Organization, Mito Medical Center, Ibaraki, Japan.
authors: Koichi
authors: K
authors: Kozaki
authors: Department of Urology, National Hospital Organization, Mito Medical Center, Ibaraki, Japan.
authors: Masahiro
authors: M
authors: IInuma
authors: Department of Clinical Engineering, National Hospital Organization, Mito Medical Center, Ibaraki, Japan.
authors: Tomoyuki
authors: T
authors: Takagi
authors: Department of Clinical Engineering, National Hospital Organization, Mito Medical Center, Ibaraki, Japan.
authors: Takanori
authors: T
authors: Fukuda
authors: Department of Clinical Engineering, National Hospital Organization, Mito Medical Center, Ibaraki, Japan.
authors: Takaya
authors: T
authors: Sanpei
authors: Department of Clinical Engineering, National Hospital Organization, Mito Medical Center, Ibaraki, Japan.
authors: Yusuke
authors: Y
authors: Terunuma
authors: Department of Clinical Engineering, National Hospital Organization, Mito Medical Center, Ibaraki, Japan.
authors: Yoshiharu
authors: Y
authors: Yatabe
authors: Department of Clinical Engineering, National Hospital Organization, Mito Medical Center, Ibaraki, Japan.
authors: Kazuhiro
authors: K
authors: Akano
mesh_terms: D000368:Aged; D000418:Albumins / Q000378:metabolism; D001201:Ascites / Q000378:metabolism*; D001202:Ascitic Fluid / Q000378:metabolism*; D001798:Blood Proteins / Q000378:metabolism; D002474:Cell-Free System; D005260:Female; D005374:Filtration / Q000379:methods*; D006801:Humans; D007262:Infusions, Intravenous; D008103:Liver Cirrhosis / Q000378:metabolism / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D000418:Albumins; D001798:Blood Proteins
keywords: Blood products; Cell-free and concentrated ascites reinfusion therapy; Decompensated liver cirrhosis; Refractory Ascites; Renal function