ArticleLiver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society2020
Improvement in Quality of Life and Decrease in Large-Volume Paracentesis Requirements With the Automated Low-Flow Ascites Pump.
Article in Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 1 of them a synthesis that pooled it.
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16 citing papers in PubMed, 1 synthesis or guideline pooled it, 33 citations in OpenAlex.
- Patient-reported and caregiver-reported outcomes in refractory ascites secondary to cirrhosis: A systematic review and meta-analysis.Hepatology communications · 2026Pooled it
- HEALTH-RELATED QUALITY OF LIFE IN CHRONIC LIVER DISEASE: CLINICAL BURDEN, DETERMINANTS, AND IMPLICATIONS FOR PATIENT-CENTERED CARE.Arquivos de gastroenterologia · 2026Review
- Refractory Ascites in Patients With Cirrhosis.JGH open : an open access journal of gastroenterology and hepatology · 2025Article
- Drainage of ascites in cirrhosis.World journal of hepatology · 2024Review
- Innovative Management of a Difficult Case of Hepatic Hydrothorax.ACG case reports journal · 2024Article
- A soft, bioinspired artificial lymphatic system for interactive ascites transfer.Bioengineering & translational medicine · 2023Article
- Innovative approaches to the management of ascites in cirrhosis.JHEP reports : innovation in hepatology · 2023Review
- Cell-free and concentrated ascites reinfusion therapy for refractory massive cardiac ascites in an adult with single ventricle haemodynamics: a case report.European heart journal. Case reports · 2023Article
- Management of refractory ascites.Clinical and molecular hepatology · 2023Review
- Final safety and efficacy results from a 106 real-world patients registry with an ascites-mobilizing pump.Liver international : official journal of the International Association for the Study of the Liver · 2022Observational
- AASLD Practice Guidance: Palliative care and symptom-based management in decompensated cirrhosis.Hepatology (Baltimore, Md.) · 2022Article
- AlfapumpWorld journal of hepatology · 2022Review
- Consensus care recommendations for alfapumpBMC gastroenterology · 2022Article
- Authors' reply: Comment on: Clinical implications of prompt ascitic drain removal in cirrhosis with refractory ascites.Singapore medical journal · 2021Article
- Reply.Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society · 2020Article
- HEP-Net opinion on the management of ascites and its complications in the setting of decompensated cirrhosis in the resource constrained environment of Pakistan.Pakistan journal of medical sciencesArticle
Corrections and comments
- Commented on byReply.2020
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Authors and funding
9 authors at 6 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The automated low-flow ascites pump (alfapump) is an implantable device that drains ascites directly into the urinary bladder. We studied its safety (absence of serious complications) and efficacy (decreased large-volume paracentesis [LVP] requirement and improved quality of life [QoL]) in the management of ascites in a cohort of North American patients with cirrhosis and recurrent ascites ineligible for transjugular intrahepatic portosystemic shunt (TIPS). QoL was measured by the Chronic Liver Disease Questionnaire (CLDQ) and Ascites Questionnaire (Ascites Q). Following alfapump implantation, patients were monitored for ascites control, laboratory abnormalities, QoL, adverse events, and survival at 12 months. A total of 30 patients (60.0 ± 9.9 years; 57% male; Model for End-Stage Liver Disease score, 11.4 ± 2.7) received an alfapump, mostly by an interventional radiology approach (97%), followed by longterm prophylactic antibiotics. The alfapump removed a mean ascites volume of 230.6 ± 148.9 L/patient at 12 months, dramatically reducing the mean LVP frequency from 2.4 ± 1.4/patient/month before pump implantation to 0.2 ± 0.4/patient/month after pump implantation. All surviving patients had improved QoL (baseline versus 3 months; CLDQ, 3.9 ± 1.21 versus 5.0 ± 1.0; Ascites Q, 51.7 ± 21.9 versus 26.7 ± 18.6; P < 0.001 for both) and a better biochemical index of nutritional status (prealbumin 87.8 ± 37.5 versus 102.9 ± 45.3 mg/L at 3 months; P = 0.04). Bacterial infections (15 events in 13 patients), electrolyte abnormalities (11 events in 6 patients), and renal complications (11 events in 9 patients) were the most common severe adverse events. By 12 months, 4 patients died from complications of cirrhosis. Alfapump insertion may be a definitive treatment for refractory ascites in cirrhosis, especially in patients who are not TIPS candidates.
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