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Therap Adv Gastroenterol. 2017 Feb;10(2):283-292. doi: 10.1177/1756283X16684688. Epub 2017 Jan 5.

Automated low-flow ascites pump for the treatment of cirrhotic patients with refractory ascites.

Author information

1
Hepatology, Clinic of Visceral Surgery and Medicine, Inselspital, Bern, Switzerland Department of Clinical Research, University of Bern, Switzerland.
2
Visceral Surgery, Clinic of Visceral Surgery and Medicine, Inselspital, Bern, Switzerland Department of Clinical Research, University of Bern, Switzerland.
3
Hepatology, Clinic of Visceral Surgery and Medicine, Inselspital, Department of Clinical Research, University of Bern, 3010 Bern, Switzerland.

Abstract

Cirrhotic patients with refractory ascites (RA) can be treated with repeated large volume paracentesis (LVP), with the insertion of a transjugular intrahepatic portosystemic shunt (TIPS) or with liver transplantation. However, side effects and complications of these therapeutic options, as well as organ shortage, warrant the development of novel treatments. The automated low-flow ascites pump (alfapump®) is a subcutaneously-implanted novel battery-driven device that pumps ascitic fluid from the peritoneal cavity into the urinary bladder. Ascites can therefore be aspirated in a time- and volume-controlled mode and evacuated by urination. Here we review the currently available data about patient selection, efficacy and safety of the alfapump and provide recommendations for the management of patients treated with this new method.

KEYWORDS:

albumin; cirrhosis; decompensation; diuretics; spontaneous bacterial peritonitis

Conflict of interest statement

Conflict of interest statement: Guido Stirnimann received speaker fees from Sequana Medical (Zürich, Switzerland). Andrea De Gottardi received speaker fees and a research grant from Sequana Medical. Vanessa Banz and Federico Storni have no conflict of interest to declare.

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