Cell-Free and Concentrated Ascites Reinfusion Therapy for Refractory Ascites Following Pediatric Liver Transplantation.
In a retrospective series of 10 pediatric living-donor liver-transplant recipients receiving 92 CART sessions for refractory ascites, ascites volume was substantially reduced after concentration, approximately 70% of several proteins was recovered, and no serious adverse events were observed.
Open original publication →What the AI sees
In a retrospective series of 10 pediatric living-donor liver-transplant recipients receiving 92 CART sessions for refractory ascites, ascites volume was substantially reduced after concentration, approximately 70% of several proteins was recovered, and no serious adverse events were observed.
Research significance
The record provides evidence that CART can concentrate refractory post-transplant ascites and recover circulating proteins with lower reinfusion volume; it remains an inference requiring prospective testing that this approach improves fluid control, nutritional or coagulation status, treatment tolerance, or clinical outcomes in pediatric transplant or oncology populations.
Source abstract
INTRODUCTION: Cell-free and concentrated ascites reinfusion therapy (CART) has been widely used for malignant ascites and decompensated cirrhosis, but its perioperative application remains unclear. We evaluated CART after pediatric living donor liver transplantation (LDLT). METHODS: We retrospectively reviewed pediatric LDLT recipients who underwent CART for refractory ascites. Changes in ascites volume, protein recovery rates including albumin and immunoglobulin G (IgG), and adverse events were analyzed. RESULTS: Ten recipients underwent 92 CART sessions. Median ascites volume decreased from 1785 mL to 362 mL after concentration. Median recovery rates were 70.1% for total protein, 71.8% for albumin, 72.0% for IgG, 76.2% for antithrombin III, and 109.4% for coagulation factor XIII. Larger ascites volumes were weakly associated with higher recovery efficiency. No serious adverse events occurred. CONCLUSIONS: CART may be a safe and useful option for managing refractory ascites and protein recovery after pediatric LT while minimizing reinfusion volume.