Novel cell-free and concentrated ascites reinfusion therapy (KM-CART) for refractory ascites associated with cancerous peritonitis: its effect and future perspectives

Background We have actively carried out cell-free and concentrated ascites reinfusion therapy (CART) for refractory ascites. However, with conventional CART, the membrane becomes clogged after processing about 2 L of cancerous ascites fluid due to the fact that it is rich in cellular and mucous comp...

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Bibliographic Details
Published in:International journal of clinical oncology 2011-08, Vol.16 (4), p.395-400
Main Authors: Matsusaki, Keisuke, Ohta, Keiichiro, Yoshizawa, Akitaka, Gyoda, Yasuaki
Format: Article
Language:English
Subjects:
Abdomen
Ascites - therapy
Ascitic Fluid
Cancer
Cancer Research
Cell-Free System
Female
Humans
Infectious diseases
Male
Medicine
Medicine & Public Health
Neoplasms - therapy
Oncology
Original Article
Peritonitis - therapy
Surgical Oncology
Therapy
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Summary:Background We have actively carried out cell-free and concentrated ascites reinfusion therapy (CART) for refractory ascites. However, with conventional CART, the membrane becomes clogged after processing about 2 L of cancerous ascites fluid due to the fact that it is rich in cellular and mucous components; it is therefore difficult to process the entire volume of collected ascites. Methods We developed KM-CART which includes a membrane cleaning function, and applied it in 73 cases of cancerous ascites, after its basic functions had been evaluated in 11 cases of refractory cancerous ascites. Results On average, using KM-CART, 6.4 L (range 1.7–14.9 L) of ascites were filtrated and concentrated to 0.8 L (0.2–2.0 L) in 57 min (5–129 min); the membrane was cleaned an average of three times (range 0–10 times) and this enabled the processing of more ascites in a shorter period. In addition, the circuit and the handling were both markedly simple, and fever, which has been the most notable adverse effect with the conventional system, was not an issue. Conclusion Since KM-CART was safe and is expected to improve the subjective symptoms and general condition of the patient, it is proposed that this novel system should actively be used not only for palliation but also as supplementary treatment for cancerous peritonitis.
ISSN:1341-9625
1437-7772
DOI:10.1007/s10147-011-0199-1