[Cell-Free Ascites Reinfusion Therapy(CART)Modified by Keisuke Matsusaki(KM-CART)at Our Hospital].

Refractory ascites causes distress in patients with cancer. Cell-free and concentrated ascites reinfusion therapy(CART)is an option for the treatment of ascites. Conventional CART had drawbacks in terms of the volume of ascites it could treat and the complications it caused. As a result, a modified form of CART(KM-CART)was developed. The current study retrospectively examined the effectiveness and safety of KM-CART in patients with cancer. Nineteen patients with cancer underwent KMCART a total of 30 times between March 2017 and January 2018. The volume of the collected ascitic fluid was 7.0±2.6 L, and the albumin(Alb)concentration in the reinfused ascitic fluid was 52.6±31.4 g. Serum Alb level after KM-CART did not decrease from the pretreatment level, while serum creatinine(Cr)level decreased significantly. Abdominal girth and bilateral thigh circumference decreased significantly, and appetite improved. Adverse events were noted in the form of liver dysfunction( noted once)and postrenal failure(noted once), but both patients recovered with subsequent treatment. A decrease in the blood pressure was noted duringparacentesis and reinfusion of ascitic fluid, but blood pressure remained within an acceptable range, and a fever was not noted. KM-CART can treat a large volume of ascites and facilitates the treatment while causingfew adverse events. KM-CART is useful for ascites and greatly improves the quality of life(QOL)for patients with cancer.

[Cell-Free and Concentrated Ascites Reinfusion Therapy for Malignant Intractable Ascites from Colorectal Cancer].

Malignant intractable ascites worsens not only patient symptoms but also their daily activities. It often leads to a patient discontinuing or postponing chemotherapy. In the present study, we introduced cell-free and concentrated ascites reinfusion therapy(CART)for malignant intractable ascites from colorectal cancer. Six patients underwent 12 CART treatments using AHF-WMO as the ascites filterand AHF-UP as the concentrator(Asahi Kasei Medical Co., Ltd.)from January 2014 to January 2017. The patients included 2 men and 4 women aged 67-89 years. Primary locations were 3 rectums, 1 transverse colon, 1 descending colon, and 1 cecum. Five patients had peritoneal dissemination, and 1 patient had liver metastasis. All the patients were administrated diuretics, but they were all refractory to the treatment. The median punctured ascites volume was 3,850 mL, and the ascites reinfusion after CART was 485 mL, the median concentration was 7.5. Only one patient had a fever. Performance status(PS)improved significantly after the treatment, and appetite score also improved. One patient was fit to undergo chemotherapy after the treatment. In summary, we found that CART is a safe and acceptable procedure for malignant intractable ascites in colorectal cancer patients.