Abstract
Background. Spontaneous bacterial peritonitis is a frequent and serious complication of cirrhotic
ascites. An important defense mechanism of ascites against infection is opsonic activity,
where the most important part is played by specific antibodies and C3 and C4 components
of complement. The authors wanted to find out whether reinfusion of concentrated ascites
or paracentesis can influence this activity. Methods. Twenty-six patients with cirrhosis of the liver and refractory ascites not corresponding
to salt restriction and diuretics were divided into two groups. In 14 patients, a
total of 25 therapeutic paracenteses were made; in 12 patients, a total of 19 reinfusions
of concentrated ascites were performed intraperitoneally. In all patients, levels
of IgG, IgA, IgM, C3 and C4 components of complement were assessed in ascites before
and 24 h after the intervention. Results. After paracentesis no change of the investigated parameters was found. Reinfusion
of concentrated ascites, on the other hand, led to a significant rise of IgG, IgA,
IgM, C3 and C4 at the 0.5% level of significance. Conclusion. Treatment of refractory ascites by ultrafiltration and reinfusion intraperitoneally
seems to increase opsonic activity of ascites and could be useful in the prevention
of the development of spontaneous bacterial peritonitis.
Keywords
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Article info
Publication history
Accepted:
September 6,
1999
Received in revised form:
March 10,
1999
Received:
March 9,
1999
Identification
Copyright
© 1999 Elsevier Science B.V. Published by Elsevier Inc. All rights reserved.
