Novel Membrane Designed Polyether Sulfone Filter Reduces Filtration Membrane Obstruction Rate in Drop-Type With Adjustable Concentrator Cell-Free and Concentrated Ascites Reinfusion Therapy (DC-CART)

Background: In cell-free and concentrated ascites reinfusion therapy (CART), filtration membrane obstruction during the ascites processing step is an important clinical problem. A novel membrane designed polyether sulfone filter (n-PES) was developed to reduce filter membrane obstruction. However, no clinical studies have compared the performance of n-PES filters with that of conventional filters. Therefore, we aimed to assess whether n-PES filters reduce membrane obstruction compared to conventional polyethylene (PE) filters during CART ascites processing.

Methods: This was a single-center, retrospective, observational, controlled cohort study. We compared ascites processing records from the drop-type with adjustable concentrator CART (DC-CART) sessions that used n-PES filters with those that used conventional PE filters. The primary outcome was the occurrence rate of membrane obstruction. Propensity score matching was used to assemble DC-CART sessions with comparable baseline ascites characteristics.

Results: Among the 173 DC-CART sessions, 31 sessions using n-PES filters and 31 using PE filters with similar propensity scores were included in the analysis. The rate of filter membrane obstruction was significantly lower in the n-PES group than in the PE group (p = 0.049). Additionally, the total treatment time was significantly shorter for the n-PES group (p = 0.006). No sessions experienced issues with the processing procedure.

Conclusion: This is the first study to demonstrate that an n-PES filter reduces the incidence of filter membrane obstruction in clinical CART sessions using human ascites. The n-PES filter may reduce the burden on the medical staff performing CART.