Introduction: Cell-free and concentrated ascites reinfusion therapy (CART) is used for the treatment of diuretic-resistant ascites. An increase in circuit pressure and clogging of the filtration membrane often occur in CART for malignant ascites.
Methods: To clarify the precise mechanism of filter clogging, we performed an ultrastructural observation study of the filtration membrane after the filtration of malignant ascites.
Results: The deposition on the filtration membrane was composed of blood cells, fibrin, or both. Cellular deposition was associated with a greater number of blood cells in the original ascites fluid. In contrast, fibrin deposition was associated with higher levels of interleukin-6, α1-antitrypsin, haptoglobin, and fibrinogen/fibrin degradation products.
Conclusion: Our results suggest that the specific pathophysiologies of malignancy (such as inflammation or coagulation/fibrinolysis) and characteristics of malignant ascites (highly concentrated and cell-rich) are associated with clogging of the filtration membrane during CART.
Keywords: ascites; cancer; filtration; membranes; scanning electron microscopy.
© 2021 The Authors. Therapeutic Apheresis and Dialysis published by John Wiley & Sons Australia, Ltd on behalf of International Society for Apheresis, Japanese Society for Apheresis, and Japanese Society for Dialysis Therapy.