Abstract
Fever, for which reinfused Endotoxin(Et) may be responsible, often develops after infusion of cell-free concentrated ascites. We developed an efficient method of Et removal from reinfused ascites to prevent fever. For the basic study, 3L of 2% albumin and 30pg/ml Et solution in physiological saline was concentrated and detoxicated by the following methods; (1) usual method using AHF-UN (Asahi) or Cella-filter (Kuraray), (2) ad-sorption method by the usual method after adsorption with the charcoal column N-50 (Asahi), and (3) EVAL-1A method using a high-permeable membrane filter (Evaflux-1A) (Kuraray). The sub-jects were five patients with intractable ascites. 2.5-4.0L of cell-free ascites, prepared with AHF-MA (Asahi) or PVA (Kuraray), was treated according to one of the above mentioned methods, and was reinfused into the vein for 10 hours, then, body temperature was measured during the following 24 hours. The quantitative Et assay was performed with Endospecy(Seikagakukogyo). The removal rate of Et in the cell-free ascites was 46.5% by the usual method, 63.6% by the adsorption method, and 65.6% by EVAL-1A method. The EVAL-1A method and adsorption method were significantly more efficient than the usual method as to Et in ascites as well as in albumin solution. There was no significant difference in the protein remaining rate among the three methods. The degree of in-crease in temparature was significantly correlated with the quantity of infused Et. The EVAL-1A method is practical and useful to remove Et from ascites prior to reinfusion, and to prevent fever.
