Togami S, Hori S, Kamio M, Matsuo T, Yoshinaga M, Douchi T
Eur J Gynaecol Oncol. 2014;35(3):301-3.
Cell-free and concentrated ascites reinfusion therapy (CART) is intended to treat patients by ultrafiltration and reinfusion of their refractory ascites. In the CART system, bacteria and cancer cells in removed massive ascites are filtrated. Then, water is removed in the condenser, resulting in a higher protein concentration. The purpose of this study was to assess the clinical usefulness of CART in the treatment of refractory massive ascites in patients with cancerous peritonitis.
CART was performed 13 times in four patients with ovarian and endometrial cancer.
Autologous protein with a higher concentration was intravenously administered. The amount of aspirated and condensed ascites was 3,190 +/- 1,086 ml (975 4,500 ml) and 538 +/- 249 ml (100 - 860 ml), respectively. Condensed albumin, albumin concentration, and concentration time were 43.2 +/- 25.8 g, 8.2 +/- 3.3 g/dl, and 73.3 +/- 24.8 min (28 - 122 min), respectively. CART was effective in maintaining serum albumin concentrations, and it is possible to repeat infusion. During CART, patients performance status was 1-2 and vital signs were stable except for mild elevations in body temperature. Daily life was maintained without serious side-effects.
The use of CART for gynecological cancer patients with refractory massive ascites due to cancerous peritonitis contributes to improvements in quality of life and relief of symptoms. With autologous infusion of condensed ascites, patients can avoid infection, allergic reactions, and administration of expensive blood products.
无细胞浓缩腹水回输疗法（CART）旨在通过对难治性腹水进行超滤和回输来治疗患者。在CART系统中，对抽取的大量腹水中的细菌和癌细胞进行过滤。然后，在冷凝器中去除水分，从而提高蛋白质浓度。本研究的目的是评估CART在治疗癌性腹膜炎患者难治性大量腹水中的临床实用性。
对4例卵巢癌和子宫内膜癌患者进行了13次CART治疗。
静脉输注了浓度更高的自体蛋白。抽取和浓缩的腹水量分别为3190±1086ml（975 - 4500ml）和538±249ml（100 - 860ml）。浓缩白蛋白、白蛋白浓度和浓缩时间分别为43.2±25.8g、8.2±3.3g/dl和73.3±24.8分钟（28 - 122分钟）。CART在维持血清白蛋白浓度方面有效，且可以重复输注。在CART治疗期间，患者的体能状态为1 - 2级，生命体征稳定，体温略有升高除外。患者能够维持日常生活，无严重副作用。
对于因癌性腹膜炎导致难治性大量腹水的妇科癌症患者，使用CART有助于改善生活质量和缓解症状。通过自体输注浓缩腹水，患者可以避免感染、过敏反应以及昂贵血液制品的输注。
