Characteristics of Patients and Their Ascites Who Underwent Repeated Cell‐Free and Concentrated Ascites Reinfusion Therapy

Maeda, Sayako; Yabuuchi, Junko; Nobuta, Hiroshi; Makiishi, Tetsuya; Hirose, Katsumi

doi:10.1111/1744-9987.12343

Cited by 9 publications

(9 citation statements)

References 7 publications

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“…Biologically clean ascites were obtained by paracentesis under local anesthesia. Drainage was continued until flow stopped spontaneously or was interrupted at the physicians' judgment (32,33). We confirmed that endotoxins were not detected in the collected ascites, as it is known that CART is unable to eliminate endotoxin with filtration (34).…”

Section: Methodssupporting

confidence: 67%

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Cell‐Free and Concentrated Ascites Reinfusion Therapy for Decompensated Liver Cirrhosis

et al. 2016

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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.

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Section: Methodssupporting

confidence: 67%

“…CART is an expensive and time-consuming method. Therefore, it is important to produce a suitable CART method and determine appropriate patients' indications for CART (26,32).…”

mentioning

confidence: 99%

Cell‐Free and Concentrated Ascites Reinfusion Therapy for Decompensated Liver Cirrhosis

et al. 2016

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“…Drainage was continued until flow stopped spontaneously or was interrupted at the physicians' discretion [4,5]. We confirmed that endotoxins were not detected in the collected ascites, as it is known that CART is unable to eliminate endotoxin with filtration [6].…”

Section: Cart Proceduressupporting

confidence: 68%

“…CART is an expensive and timeconsuming method. Therefore, it is important to produce suitable CART method and determine appropriate patient's indication of CART [3,4].…”

Section: Discussionmentioning

confidence: 99%

Safety and Effectiveness of Cell-Free Concentrated Ascites Reinfusion Therapy in Gastric Cancer Patients with Refractory Ascites

Kozaki¹,

Takagi²,

Fukuda³

et al. 2017

Anat Physiol

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Patients of gastrointestinal carcinoma with the refractory ascites are often chemotherapy-resistant cancer patients, and these patients are good indication of the cell-free and concentrated ascites reinfusion therapy (CART). CART is expected to improve symptoms associated with refractory ascites of patients with gastrointestinal carcinoma.The aim of this study is to evaluate the safety and efficacy of the CART system performed on the gastric cancer patients with massive refractory ascites. In this retrospective observational study, we evaluated 5 CART processes performed 3 patients with the gastric cancer. We evaluated the effectiveness and adverse events during CART procedures. The amounts of collected and concentrated ascites were 2410.0 ± 1762.6 ml (mean ± SD), and concentration ratio was 10.5 ± 4.3 times. The amount of collected protein in ascites was 3.4 ± 1.3 g/dl, and concentration ratio of protein was 4.2 ± 2.0 times. Serum protein level was no significant different between before and two weeks after CART. No patients received an albumin (25% albumin preparation Alb) transfusion within two weeks prior to the first CART. Thus, CART allowed for the reduction doses of Alb to be administered. CART has been reported to cause two adverse reactions as elevation of body temperature and decrease in blood pressure. In our study, decreased blood pressure was not observed in all patients, and body temperature significantly rose after CART, but there were no patients more than 37 degrees.In patients with refractory ascites of the gastric cancer patients in whom complete cure cannot be expected, CART improves their QOL and, in terms of medical economy, allows for the reduction doses of Alb. CART can be effectively applied as a palliative procedure for refractory ascites of the gastric cancer patients.

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“…Nevertheless, this study revealed that most of the patients underwent multiple CART sessions. Maeda et al reported that total protein levels were high and prognosis was favorable in the patients who underwent ≥ 5sessions [6]. Also, long intervals between CART sessions and a good prognosis were reported in gynecologic cancer patients who had undergone chemotherapy [7].…”

Section: Discussionmentioning

confidence: 99%

Safety and efficacy of cell-free and concentrated ascites reinfusion therapy (CART) in refractory ascites: Post-marketing surveillance results

et al. 2017

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We performed post-marketing surveillance to evaluate the safety and efficacy of cell-free and concentrated ascites reinfusion therapy (CART). In total, 356 CART sessions in 147 patients at 22 centers were performed. The most common primary disease was cancer (128 cases, 300 sessions). Mean amount of ascites collected was 3.7 L, and mean concentration ratio was 9.2. Mean amount of reinfused protein was 67.8 g (recovery rate, 72.0%). Performance status, dietary intake, urine volume, body weight and abdominal circumference were significantly improved after CART. Body temperature increased significantly, by 0.3°C on average. Concomitant steroids and/or NSAIDs use before reinfusion was significantly and negatively associated with increases in body temperature. Most adverse events were fever and chills. This study examined a large number of patients compared with previous studies, and showed that CART is an effective and relatively safe treatment for refractory ascites, such as malignant ascites.

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Characteristics of Patients and Their Ascites Who Underwent Repeated Cell‐Free and Concentrated Ascites Reinfusion Therapy

Cited by 9 publications

References 7 publications

Cell‐Free and Concentrated Ascites Reinfusion Therapy for Decompensated Liver Cirrhosis

Cell‐Free and Concentrated Ascites Reinfusion Therapy for Decompensated Liver Cirrhosis

Safety and Effectiveness of Cell-Free Concentrated Ascites Reinfusion Therapy in Gastric Cancer Patients with Refractory Ascites

Safety and efficacy of cell-free and concentrated ascites reinfusion therapy (CART) in refractory ascites: Post-marketing surveillance results

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