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

Abstract

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.