Inui Keita, Yamada Yosuke, Aomura Daiki, Sonoda Kosuke, Harada Makoto, Hashimoto Koji, Kamijo Yuji
Department of Nephrology, Shinshu University School of Medicine, Matsumoto, Nagano, Japan.
Artif Organs. 2025 Apr;49(4):592-599. doi: 10.1111/aor.14932. Epub 2024 Dec 23.
In cell-free and concentrated ascites reinfusion therapy (CART), filtration membrane obstruction during the ascites processing step is an important clinical problem. A novel membrane designed polyether sulfone filter (n-PES) was developed to reduce filter membrane obstruction. However, no clinical studies have compared the performance of n-PES filters with that of conventional filters. Therefore, we aimed to assess whether n-PES filters reduce membrane obstruction compared to conventional polyethylene (PE) filters during CART ascites processing.
This was a single-center, retrospective, observational, controlled cohort study. We compared ascites processing records from the drop-type with adjustable concentrator CART (DC-CART) sessions that used n-PES filters with those that used conventional PE filters. The primary outcome was the occurrence rate of membrane obstruction. Propensity score matching was used to assemble DC-CART sessions with comparable baseline ascites characteristics.
Among the 173 DC-CART sessions, 31 sessions using n-PES filters and 31 using PE filters with similar propensity scores were included in the analysis. The rate of filter membrane obstruction was significantly lower in the n-PES group than in the PE group (p = 0.049). Additionally, the total treatment time was significantly shorter for the n-PES group (p = 0.006). No sessions experienced issues with the processing procedure.
This is the first study to demonstrate that an n-PES filter reduces the incidence of filter membrane obstruction in clinical CART sessions using human ascites. The n-PES filter may reduce the burden on the medical staff performing CART.
在无细胞浓缩腹水回输疗法(CART)中,腹水处理步骤中的滤膜阻塞是一个重要的临床问题。一种新型的膜设计聚醚砜过滤器(n-PES)被开发出来以减少滤膜阻塞。然而,尚无临床研究比较n-PES过滤器与传统过滤器的性能。因此,我们旨在评估在CART腹水处理过程中,与传统聚乙烯(PE)过滤器相比,n-PES过滤器是否能减少膜阻塞。
这是一项单中心、回顾性、观察性、对照队列研究。我们比较了使用n-PES过滤器的滴注式可调浓缩器CART(DC-CART)疗程与使用传统PE过滤器的DC-CART疗程的腹水处理记录。主要结局是膜阻塞的发生率。采用倾向得分匹配法来汇集具有可比基线腹水特征的DC-CART疗程。
在173个DC-CART疗程中,分析纳入了31个使用n-PES过滤器和31个使用具有相似倾向得分的PE过滤器的疗程。n-PES组的滤膜阻塞率显著低于PE组(p = 0.049)。此外,n-PES组的总治疗时间显著更短(p = 0.006)。所有疗程在处理过程中均未出现问题。
这是第一项证明n-PES过滤器可降低使用人腹水的临床CART疗程中滤膜阻塞发生率的研究。n-PES过滤器可能减轻进行CART的医务人员的负担。