PATHOGENETIC RATIONALE FOR THE NECESSITY OF REINFUSION OF ASCITIC FLUID IN PATIENTS WITH LIVER CIRRHOSIS

Abstract

Liver cirrhosis is a serious disease, being the 11th most frequent cause of death worldwide, with 50% of patients dying within 5 years. Ascites in cirrhosis develops as a result of various pathogenetic factors: hyperaldosteronism, fluid accumulation in the body, portal hypertension, increased lymph production and impaired outflow, reduced drainage function of the parietal peritoneum, autoimmune dysproteinemia, and disturbance of plasma colloid-oncotic balance. Modern medicine offers several methods for treating ascites, including drug therapy, serial laparocenteses with removal of large volumes of fluid, transjugular intrahepatic portosystemic shunts, implanted drainage devices, as well as acellular and concentrated reinfusion therapy. Each of these approaches has its advantages and limitations, and choosing the optimal treatment strategy often presents a challenging task. This article discusses modern methods of ascites treatment using reinfusion with the Fresenius preparation.