Reinfusion of concentrated ascitic fluid versus total paracentesis: A randomized prospective trial

Agnese Graziotto, Lorenzo Rossaro, Paolo Inturri, Mario Salvagnini

Research output: Contribution to journalArticle

21 Scopus citations

Abstract

We compared the efficacy and safety of apheresis and reinfusion of concentrated ascites (ARCA) versus total paracentesis plus intravenous albumin (PARA) in a prospective trial on cirrhotic patients with tense ascites. Twenty-four patients were randomized to either ARCA (N = 12) or PARA (N = 12), and followed for two years. Sex, age, child's class, and renal and liver function were similar in the two groups. The times of the procedures were 2.7 ± 1.0 (ARCA) vs 2.2 ± 1.1 (PARA) hr, with removal of 8.8 ± 3.5 (ARCA) and 6.9 ± 3.4 (PARA) liters of ascites and intravenous infusion of 59.8 ± 35.2 (ARCA) and 42.5 ± 20.5 (PARA) g of albumin. Both procedures were safe. Biochemical signs of coagulative disturbances having no clinical relevance were observed after ARCA, with an increase in prothrombin time (P = 0.005) and serum FSP (P = 0.02). No significant changes in renal function, serum albumin, or plasma and urinary electrolytes were shown. Plasma renin activity increased after PARA (P = 0.02) and plasma atrial natriuretic factor increased after ARCA (P = 0.008), although no differences were observed in diuresis in the immediate follow-up. During the long-term follow-up, patient survival and recurrence of tense ascites were the same in both groups. We conclude that apheresis and reinfusion of concentrated ascites are as safe and effective as total paracentesis with albumin infusion for the treatment of tense ascites in cirrhotic patients.

Original languageEnglish (US)
Pages (from-to)1708-1714
Number of pages7
JournalDigestive Diseases and Sciences
Volume42
Issue number8
DOIs
StatePublished - 1997
Externally publishedYes

Keywords

  • Albumin
  • Concentrated ascites reinfusion
  • Liver cirrhosis
  • Paracentesis

ASJC Scopus subject areas

  • Gastroenterology

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