Weil-Verhoeven D, Di Martino V, Stirnimann G, Cervoni JP, Nguyen-Khac E, Thévenot T. Alfapump® implantable device in management of refractory ascites: An update. World J Hepatol 2022; 14(7): 1344-1356 [PMID: 36158913 DOI: 10.4254/wjh.v14.i7.1344]
Corresponding Author of This Article
Delphine Weil-Verhoeven, MD, PhD, Doctor, Service d’Hépatologie Et Soins Intensifs Digestifs, CHRU Jean Minjoz, 3 Boulevard Fleming, Besançon 25030, France. dweil@chu-besancon.fr
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Hepatol. Jul 27, 2022; 14(7): 1344-1356 Published online Jul 27, 2022. doi: 10.4254/wjh.v14.i7.1344
Alfapump® implantable device in management of refractory ascites: An update
Delphine Weil-Verhoeven, Vincent Di Martino, Guido Stirnimann, Jean Paul Cervoni, Eric Nguyen-Khac, Thierry Thévenot
Delphine Weil-Verhoeven, Vincent Di Martino, Jean Paul Cervoni, Thierry Thévenot, Service d’Hépatologie Et Soins Intensifs Digestifs, CHRU Jean Minjoz, Besançon 25030, France
Delphine Weil-Verhoeven, Vincent Di Martino, Thierry Thévenot, EA 4266 EPILAB, Université de Bourgogne Franche-Comté, Besançon 25030, France
Guido Stirnimann, Department of Visceral Surgery and Medicine, Inselspital University Hospital and University of Bern, Bern 3010, Switzerland
Eric Nguyen-Khac, Service d’Hépato-Gastroentérologie, CHU Amiens-Picardie, Amiens 80080, France
Author contributions: Weil-Verhoeven D designed the research and wrote the paper; Weil-Verhoeven D and Thévenot T analyzed the data; Thévenot T, Di Martino V, Stirnimann G, Cervoni J-P, and Nguyen-Khac E made critical revisions related to important content of the revised manuscript; Weil-Verhoeven D, Thévenot T, Di Martino V, Stirnimann G, Cervoni J-P, and Nguyen-Khac E provided the final approval of the version to be published.
Conflict-of-interest statement: Stirnimann G has received support for travel and meeting attendance, served as a speaker, and participated in Advisory Boards for Sequana Medical. There is no conflict of interest associated with any of the senior author or other coauthors contributed their efforts in this manuscript.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Delphine Weil-Verhoeven, MD, PhD, Doctor, Service d’Hépatologie Et Soins Intensifs Digestifs, CHRU Jean Minjoz, 3 Boulevard Fleming, Besançon 25030, France. dweil@chu-besancon.fr
Received: March 31, 2022 Peer-review started: March 31, 2022 First decision: May 12, 2022 Revised: May 30, 2022 Accepted: June 27, 2022 Article in press: June 27, 2022 Published online: July 27, 2022
Abstract
Refractory ascites (RA) is a frequent and life-threatening complication of cirrhosis. In selected patients with RA, transjugular intrahepatic portosystemic shunt (TIPS) placement and liver transplantation (LT) are currently considered the best therapeutic alternatives to repeated large volume paracentesis. In patients with a contraindication to TIPS or LT, the alfapump® system (Sequana Medical, Ghent, Belgium) has been developed to reduce the need for iterative paracentesis, and consequently to improve the quality of life and nutritional status. We report here recent data on technical progress made since the first implantation, the efficacy and tolerance of the device, the position of the pump in the therapeutic arsenal for refractory ascites, and the grey areas that remain to be clarified regarding the optimal selection of patients who are potential candidates for this treatment.
Core Tip: The alfapump® system (Sequana Medical, Ghent, Belgium) is a subcutaneous implantable device that allows the transfer of ascites from the peritoneal cavity to the bladder. In this review, we describe the practical aspects of the alfapump® device implantation, and discuss its effectiveness and safety as a treatment for refractory ascites in cirrhotic patients, based on the most recently published data.
