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In patients with decompensated cirrhosis, recurrent or refractory ascites despite diuretic use is associated with substantial morbidity and mortality. Treatment is limited to repeated large-volume paracentesis or, in select patients, transjugular intrahepatic portal systemic shunting (TIPS). Could a pump that transfers ascitic fluid to the urinary bladder help?
The alfapump is an automated, subcutaneously implanted ascites pump that moves fluid from the peritoneal cavity into the bladder. In this industry-sponsored, multicenter North American study, 40 patients with cirrhosis and recurrent or refractory ascites received standard care during 3 months of observation and then received alfapumps and were followed for 24 months postimplant…