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新型膜设计的聚醚砜过滤器可降低滴注式可调浓缩器无细胞和浓缩腹水回输疗法(DC-CART)中过滤膜的阻塞率。

Novel Membrane Designed Polyether Sulfone Filter Reduces Filtration Membrane Obstruction Rate in Drop-Type With Adjustable Concentrator Cell-Free and Concentrated Ascites Reinfusion Therapy (DC-CART).

作者信息

Inui Keita, Yamada Yosuke, Aomura Daiki, Sonoda Kosuke, Harada Makoto, Hashimoto Koji, Kamijo Yuji

机构信息

Department of Nephrology, Shinshu University School of Medicine, Matsumoto, Nagano, Japan.

出版信息

Artif Organs. 2025 Apr;49(4):592-599. doi: 10.1111/aor.14932. Epub 2024 Dec 23.

Abstract

BACKGROUND

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.

METHODS

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.

RESULTS

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.

CONCLUSION

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.

摘要

背景

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。

方法

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。

结果

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。

结论

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。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/40f0/11974482/e77f4bb2aa69/AOR-49-592-g003.jpg

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