Levocarnitine may improve the survival of patients with liver cirrhosis who undergo cell-free and concentrated ascites reinfusion therapy for refractory ascites

Cell-free and concentrated ascites reinfusion therapy (CART) is a therapeutic option against refractory ascites. The clinical outcomes of 294 CART procedures in 53 patients with cirrhosis were evaluated. In median, 5,120 mL of ascites was drained, then filtered and concentrated to 500 mL. Eventually, 56.8 g/dL of proteins (including 25.7 g/dL of albumin) was reinfused in each procedure. The median survival was 79 days. In multi-variable analysis, oral levocarnitine administration (hazard ratio, 0.311; 95% confidence interval, 0.140-0.646) was associated with mortality aside from ALBI score and concurrent malignant disease. The median survival in those with and without levocarnitine was 140 days and 38 days, respectively. Levocarnitine may con-tribute to a favorable prognosis in patients who undergo CART for refractory ascites.