Ascites filtration and reinfusion in cirrhotic patients with tense ascites efficacy and cost effectiveness

ABSTRACT

To assess the efficacy and safety of ascites filtration and reinfusion and compare its cost effective with total paracentesis plus intravenous albumin infusion in cirrhotic patients with tense ascites, in our setting. Design: Prospective open trial of the treatment. Setting: Medical Unit-11 of the Nishtar Hospital, Multan which is a teaching hospital. Patients Sixteen consecutive cirrhotic patients with recurrent tense ascites. Ten fulfilled admission criteria and completed the study. Main outcome measures: Body weight, urinary volume, serum electrolytes, platelet count, prothrombin time, and serum creatinine before the procedure and 24 hours and eight days afterwards. Ten consecutive patients [3 females, 7 males] fulfilling the criteria were selected for study, with mean age of 46.5 years [range 24-68]. Mean weight reduction was 8.2 Kg. in all patients with negligible increase after 8 days. There was insignificant [p>0.50] decrease in platelet count and increase in prothrombin time after procedure which returned to pretreatment values after eight days. Similarly insignificant increase in serum electrolytes and decrease in creatinine level was noted. A significant increase [p<0.01] in urine volume was noted which persisted after 8 days without use of diuretics. Treatment was effective in all patients. Two [20%] patients had transient fever. Cost per procedure was Rs.450 as compared to total paracentesis and infusion of albumin where cost was Rs.3900.Ascites filtration and reinfusion is an effective, safe and cheaper procedure for treatment of tense ascites. Reinfusion of the patient's concentrated proteins provides saving without compromising safety