title: Automated low-flow ascites pump for the treatment of cirrhotic patients with refractory ascites.
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.
authors.affiliation: Hepatology, Clinic of Visceral Surgery and Medicine, Inselspital, Bern, Switzerland Department of Clinical Research, University of Bern, Switzerland.
authors.forename: Guido
authors.initials: G
authors.lastname: Stirnimann
authors.affiliation: Visceral Surgery, Clinic of Visceral Surgery and Medicine, Inselspital, Bern, Switzerland Department of Clinical Research, University of Bern, Switzerland.
authors.forename: Vanessa
authors.initials: V
authors.lastname: Banz
authors.affiliation: Visceral Surgery, Clinic of Visceral Surgery and Medicine, Inselspital, Bern, Switzerland Department of Clinical Research, University of Bern, Switzerland.
authors.forename: Federico
authors.initials: F
authors.lastname: Storni
authors.affiliation: Hepatology, Clinic of Visceral Surgery and Medicine, Inselspital, Department of Clinical Research, University of Bern, 3010 Bern, Switzerland.
authors.forename: Andrea
authors.initials: A
authors.lastname: De Gottardi
keywords: albumin; cirrhosis; decompensation; diuretics; spontaneous bacterial peritonitis