BACKGROUND AND AIMS: The aim of this study was to investigate the Alfapump, an automated low-flow pump system for the treatment of refractory ascites (RA) as an alternative for repeated large-volume paracentesis in patients with contraindication for placement of a transjugular intrahepatic portosystemic shunt (TIPS) or liver transplantation. MATERIALS AND METHODS: In 21 consecutive patients with RA and contraindication for a placement of a TIPS, the Alfapump was implanted at Hannover Medical School between December 2012 and May 2016. Repeated laboratory, clinical, and microbiology data were collected and analyzed to assess the outcome of patients with an Alfapump. Half of the patients received a modified peritoneal catheter. RESULTS: Twenty-one patients with RA in end-stage liver disease and with a contraindication to TIPS placement received the Alfapump. Diuretic dosages were significantly reduced, and the number of paracentesis declined from 2.3±2.7 to 0 per week. Using the Alfapump, kidney function and serum sodium remained stable. Likewise, serum albumin remained stable in the absence of albumin infusions. Thirty-three complications (dislocation and/or blockade of the catheter, infection, pump dysfunction) related to the Alfapump were observed in 15 of 21 patients (71.4%), and 21 surgical interventions were needed in 15 patients (71.4%, 1-3 interventions per patient). A new peritoneal catheter system could significantly reduce blockage of the peritoneal catheter. CONCLUSION: The Alfapump is an effective treatment in patients with RA. However, a high rate of complications were observed, which could be reduced with a modified peritoneal catheter.
BACKGROUND AND AIMS: The aim of this study was to investigate the Alfapump, an automated low-flow pump system for the treatment of refractory ascites (RA) as an alternative for repeated large-volume paracentesis in patients with contraindication for placement of a transjugular intrahepatic portosystemic shunt (TIPS) or liver transplantation. MATERIALS AND METHODS: In 21 consecutive patients with RA and contraindication for a placement of a TIPS, the Alfapump was implanted at Hannover Medical School between December 2012 and May 2016. Repeated laboratory, clinical, and microbiology data were collected and analyzed to assess the outcome of patients with an Alfapump. Half of the patients received a modified peritoneal catheter. RESULTS: Twenty-one patients with RA in end-stage liver disease and with a contraindication to TIPS placement received the Alfapump. Diuretic dosages were significantly reduced, and the number of paracentesis declined from 2.3±2.7 to 0 per week. Using the Alfapump, kidney function and serum sodium remained stable. Likewise, serum albumin remained stable in the absence of albumin infusions. Thirty-three complications (dislocation and/or blockade of the catheter, infection, pump dysfunction) related to the Alfapump were observed in 15 of 21 patients (71.4%), and 21 surgical interventions were needed in 15 patients (71.4%, 1-3 interventions per patient). A new peritoneal catheter system could significantly reduce blockage of the peritoneal catheter. CONCLUSION: The Alfapump is an effective treatment in patients with RA. However, a high rate of complications were observed, which could be reduced with a modified peritoneal catheter.
Authors: J Dembinski; D Aranovich; V Banz; T Ehmann; I Klein; M Malago; N Richter; A A Schnitzbauer; W Staszewicz; H-M Tautenhahn; J Capel; J-M Regimbeau Journal: Langenbecks Arch Surg Date: 2020-01-08 Impact factor: 3.445
Authors: Valerie Will; Susana G Rodrigues; Guido Stirnimann; Andrea De Gottardi; Jaime Bosch; Annalisa Berzigotti Journal: United European Gastroenterol J Date: 2020-06-26 Impact factor: 4.623
Authors: Niels Kristian Aagaard; Massimo Malago; Andrea De Gottardi; Michael Thomas; Gerd Sauter; Cornelius Engelmann; David Aranovich; Michal Cohen; Thierry Thévenot; Thomas Ehmann; Jeroen Capel; Paolo Angeli; Rajiv Jalan; Guido Stirnimann Journal: BMC Gastroenterol Date: 2022-03-08 Impact factor: 3.067
Authors: Delphine Weil-Verhoeven; Vincent Di Martino; Guido Stirnimann; Jean Paul Cervoni; Eric Nguyen-Khac; Thierry Thévenot Journal: World J Hepatol Date: 2022-07-27
Authors: Guido Stirnimann; Thomas Berg; Laurent Spahr; Stefan Zeuzem; Stuart McPherson; Frank Lammert; Federico Storni; Vanessa Banz; Jana Babatz; Victor Vargas; Andreas Geier; Cornelius Engelmann; Adam Herber; Claudia Trepte; Jeroen Capel; Andrea De Gottardi Journal: Liver Int Date: 2022-07-25 Impact factor: 8.754