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Concentrated ascitic fluid reinfusion after cascade filtration in tense ascites

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Abstract

A new method for concentrated ascitic fluid reinfusion using a double ultrafiltration device is reported as 22 procedures in 20 cirrhotic patients (6 females, 14 males; median age 55 years, range 33–69) with tense, refractory ascites. Eight of the 20 patients had elevated creatinine levels. The mean time for each procedure was 189±82 min, during which a mean of 7.7 liters (1.3–13.3) of ultrafiltered ascitic fluid was removed and 613 ml (140–1700) of concentrated ascitic fluid rich in albumin (mean: 60 g, range 14–175) was reinfused. The procedure resulted in a mean weight loss of 8.1 kg (2.2–14.0) and a mean increase of 163 ml in urine output (24 hr). A reduction in the serum creatinine level (P<0.05) and an increase in the plasma atrial natriuretic factor level (P<0.02) 24 hr after reinfusion, while no changes in serum albumin, plasma and urinary electrolytes, plasma renin activity, aldosterone, and antidiuretic hormone levels were noted. Although minor evidence for a disturbance in coagulation was observed, there were no episodes of clinical bleeding. Four patients (20%) had transient chills or fever. Based upon this experience, it can be concluded that reinfusion of cascade filtrated and concentrated ascitic fluid is a rapid, safe, and effective treatment for patients with tense ascites; it appears to have less side effects than more traditional methods and importantly does not require administration of heterologous plasma derivatives.

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Authors and Affiliations

  1. Divisione di Gastroenterologia “R. Farini,” and Istituto di Medicina di Laboratorio, Ospedale Monoblocco, Universitá di Padova, Via Giustiniani, 2, 35128, Padova, Italy

    Lorenzo Rossaro MD, Agnese Graziotto MD, Stefano Bonato MD, Mario Plebani MD, David H. Van Thiel MD, Angelo Burlina MD,  Remo Naccarato MD & Mario Salvagnini MD

  2. Department of Surgery, University of Pittsburgh, 15213, Pittsburgh, Pennsylvania

    Lorenzo Rossaro MD, Agnese Graziotto MD, Stefano Bonato MD, Mario Plebani MD, David H. Van Thiel MD, Angelo Burlina MD,  Remo Naccarato MD & Mario Salvagnini MD

Authors
  1. Lorenzo Rossaro MD
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  2. Agnese Graziotto MD
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  3. Stefano Bonato MD
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  4. Mario Plebani MD
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  5. David H. Van Thiel MD
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  6. Angelo Burlina MD
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  7. Remo Naccarato MD
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  8. Mario Salvagnini MD
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Additional information

This study was done under the auspices of the R. Farini Foundation for Gastroenterological Research.

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Rossaro, L., Graziotto, A., Bonato, S. et al. Concentrated ascitic fluid reinfusion after cascade filtration in tense ascites. Digest Dis Sci 38, 903–908 (1993). https://doi.org/10.1007/BF01295918

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  • DOI: https://doi.org/10.1007/BF01295918

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