TY  - JOUR
A1  - Stirnimann, Guido
A1  - Berg, Thomas
A1  - Spahr, Laurent
A1  - Zeuzem, Stefan
A1  - McPherson, Stuart
A1  - Lammert, Frank
A1  - Storni, Federico
A1  - Banz, Vanessa
A1  - Babatz, Jana
A1  - Vargas, Victor
A1  - Geier, Andreas
A1  - Stallmach, Andreas
A1  - Engelmann, Cornelius
A1  - Trepte, Claudia
A1  - Capel, Jeroen
A1  - De Gottardi, Andrea
T1  - Treatment of refractory ascites with an automated low-flow ascites pump in patients with cirrhosis
T2  - Alimentary pharmacology & therapeutics
N2  - Background: Refractory ascites (RA) 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 (alfapump, Sequana Medical AG, Zurich, Switzerland) is an innovative treatment option for patients with RA.
Aim: To assess safety and efficacy of this treatment in patients with a contraindication to TIPSS.
Methods: Fifty-six patients (43 males; mean age 62 years) from centres in Germany, Switzerland, UK and Spain were included and followed for up to 24 months. Complications, device deficiencies, paracentesis frequency and patient survival were recorded.
Results: 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the 24-month observation period, monitoring of 3 was ongoing, 9 underwent liver transplantation, 17 patients were withdrawn due to serious adverse events and 23 patients died.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. Twenty-three pump-related reinterventions (17 patients) and 12 pump exchanges (11 patients) were required during follow-up. The pump system was explanted in 48% of patients (in 17 patients due to serious adverse events, in 9 at the time of liver transplantation and in 1 due to recovery from RA). Median frequency of paracentesis dropped from 2.17 to 0.17 per month.
Conclusions: The alfapump can expand therapeutic options for cirrhotic patients with RA. 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.
Y1  - 2017
UR  - http://publikationen.ub.uni-frankfurt.de/frontdoor/index/index/docId/45200
UR  - https://nbn-resolving.org/urn:nbn:de:hebis:30:3-452000
SN  - 1365-2036
SN  - 0269-2813
N1  - This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made. © 2017 The Authors. Alimentary Pharmacology & Therapeutics Published by John Wiley & Sons Ltd.
VL  - 46
IS  - 10
SP  - 981
EP  - 991
PB  - Blackwell Science
CY  - Oxford
ER  -