Refractory ascites is a frequent complication of cirrhosis, requiring large volume paracentesis or placement of a transjugular intrahepatic portosystemic shunt (TIPSS).
The automated low-flow ascites pump is an innovative treatment option for patients with refractory ascites.
Dr Stirnimann and colleagues from Switzerland assessed safety and efficacy of this treatment in patients with a contraindication to transjugular intrahepatic portosystemic shunt.
The team included 56 patients from centers in Germany, Switzerland, UK and Spain and followed for up to 24 months.
Complications, device deficiencies, paracentesis frequency and patient survival were recorded.
|Pump system was explanted in 48% of patients|
|Alimentary Pharmacology & Therapeutics|
At the time of this analysis, 3 patients completed the 24-month observation period, monitoring of 3 was ongoing, 9 underwent liver transplantation, 17 patients were withdrawn due to serious adverse events and 23 patients died.
Most frequently observed technical complication was blocking of the peritoneal catheter.
The researchers found that 23 pump-related reinterventions, and 12 pump exchanges were required during follow-up.
The team noted that pump system was explanted in 48% of patients.
Median frequency of paracentesis dropped from 2 to 0.17 per month.
Dr Stirnimann's team concludes, "The alfapump can expand therapeutic options for cirrhotic patients with refractory ascites."
"Continuous drainage of ascites in a closed loop automated system led to significant reduction in paracentesis frequency."
"Technical and procedural improvements are required to reduce the rate of adverse events and reinterventions."