Efficacy and Safety of Cell-free and Concentrated Ascites Reinfusion Therapy (CART)

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  • Ito,Tetsuya
    Department of Palliative Medicine, Research Hospital, The Institute of Medical Science, The University of Tokyo

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  • CARTの効果と副作用

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Various symptoms due to malignant ascites affect patients' activities in daily living, quality of life and motivation for continuing therapy during the whole course of cancer treatment. Cell-free and Concentrated Ascites Reinfusion Therapy (CART) has been applied mainly against cirrhotic ascites. CART is now attracting rising attention as one strategy against malignancy-related ascites; however it lacks a widely accepted criterion. CART caused an increase in urine output, probably due to an elevation in plasma osmolality, suggesting an improvement in diuretics resistance observed often in patients with malignant ascites. Furthermore, symptoms related to ascites accumulation were improved quantitatively in various fields, including fatigue. As fatigue is the key problem occurring frequently in paracentesis, this favorable result may account for the possible competence of CART. CART caused an elevation of body temperature, decrease in systolic blood pressure after paracentesis and platelet reduction. Our investigation confirmed all of these adverse events were mild and not clinically significant. The mechanism accounting for these favorable changes of CART is still unclear. More investigation about these phenomena is needed.

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