Efficacy of Cell-Free and Concentrated Ascites Reinfusion Therapy for Malignant Ascites - Abstract
Cell-free and concentrated Ascites Reinfusion Therapy (CART) is a treatment
method in which ascites retained by decompensated cirrhosis or cancerous peritonitis
are drained from the body. Then, separation cleaning is performed by filtering the
bacteria and tumor cells, and the autologous proteinsare concentrated and collected
so that they can be reused. Although CART is expected to improve patients’ symptoms
and Quality of Life (QOL), there have beena limited number of studies showing the
efficacy of CART in patients with Malignant Ascites (MA).In the present study, we
investigated the safety and efficacy of CART performed for 13 patients with MA
and compared the results with the efficacy of paracentesis performed for 10 patients
with MA between January 2009 and January 2013. In total, 42 CART procedures
were performed. The numbers of CART and paracentesis procedures performed per
person were 3.4±2.6 and 3.8±1.2, respectively. CART appeared to control symptoms
associated with retention of ascites, including abdominal fullness and anorexia, and the
period of inability of oral intake before death was significantly shorter in the CARTtreated patients (7.1±4.4 days) than in the paracentesis-treated patients (20.3±7.3
days; p=0.002). Moreover, the serum albumin levels were maintained in those patients
without albumin infusion, and no clinically significant adverse effects, including fever
during reinfusion, were not experienced. In conclusion, our results suggested that CART
could be performed safely and could improve symptoms associated with ascites
refractory to conventional treatment such as diuretics and salt restriction and, improve
QOL in patients with MA.