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©The Author(s) 2022.
World J Hepatol. Jul 27, 2022; 14(7): 1344-1356
Published online Jul 27, 2022. doi: 10.4254/wjh.v14.i7.1344
Published online Jul 27, 2022. doi: 10.4254/wjh.v14.i7.1344
Ref. | Study design | Main exclusion criteria | N patients | Mean age (yr) | MELD score2 | Follow-up | Efficacy of the device | Mortality during follow-up, patients, n (%) | Liver transplantation after pump implantation (%) |
Bellot et al[15], 2013 | Observational Prospective | Life expectancy < 6 mo Creatinine > 176 µmol/L in the 7 d prior to inclusion Bilirubin > 85 µmol/L Malignancy (including HCC) HE and/or GI bleeding related to portal hypertension in the 2 wk prior to inclusion | 40 | 59 | 12 | 6 mo | Number of paracentesis/mo/patient: 3.4 vs 0.24; P < 0.01 | 8 (25) | 5 (12) |
Thomas et al[20], 2015 | Observational Prospective | Na | 10 | Na | 16 | Median: 165 d (maximum: 379 d) | Number of paracentesis/mo/patient: 3.4 ± 0.8 vs 0.4 ± 1.0 P < 0.0001 | 3 (30) | 1 (10) |
Bureau et al[16], 2017 | RCT: alfapump (G1) vs iterative paracentesis (G2) | Creatinine > 176 µmol/L HCC outside Milan criteria Inability to use the device | G1: 27 G2: 31 | 61 | 12 | 6 mo | Median number of paracentesis on day 28 G1 vs G2: 0.3 vs 1.2; P < 0.001 | G1 vs G2: 22 vs 13, P = NS | 3 (11) |
Stirnimann et al[18], 2017 | Observational Prospective | Inability to use the device | 56 | 62 | 13 | Median: 5.8 mo (maximum: 26 mo) | Number of paracentesis/mo/patient: 2.9 ± 1.8 vs 0.3 ± 0.3, P = NA | 23 (41) | 9 (16) |
Solà et al[19], 2017 | Observational Prospective | Creatinine > 176 µmol/L Bilirubin > 85 µmol/L ≥ 2 urinary tract infections or SBP in the 6 mo prior to inclusion HCC outside Milan criteria | 10 | 59 | 11 | 12 mo | Number of paracentesis/3 mo/patient 7.5 vs 2.4; P = NA | 5 (50) | NA |
Solbach et al[17], 2018 | Retrospective | Na | 21 | 56 | 15 | Na | Number of paracentesis/wk/patient: 2.3 ± 2.7 vs 0; P = NA | Median survival: 153 d | 4 (19) |
Wong et al[20], 2020 | Observational Prospective | MELD score > 21 HE stage > II in the 15 d prior to inclusion > 2 systemic or local infections in the 6 mo prior to inclusion Bilirubin > 85 μmol/L Creatinine > 132 μmol/L GFR < 30 mL/min/1.73 m2 | 301 | 60 | 11 | 12 mo | Number of paracentesis/mo/patient: 2.4 ± 1.4 vs 0.2 ± 0.4; P < 0.05 | 4 (13.3) | 3 (10) |
Will et al[24], 2020 | Retrospective TIPS vs alfapump | Na | 40 | 59 | 16 | Median: 4.7 mo (maximum: 24 mo) | Number of paracentesis: no more paracentesis at 6 mo for 43% of patients | 24 (60) | 11 (28) |
Ref. | Patients (n) | AKI occurrence during follow-up | Variation in creatinine levels before vs after implantation | Peritoneal infections (n episodes) | Urinary tract infections (n episodes) |
Bellot et al[13], 2013 | 40 | 13 episodes, 11 patients | 106 vs 127 µmol/L at 3 mo (P = NA) 105 µmol/L at 6 mo (P = NA) | 12 | 3 |
Thomas et al[20], 2015 | 10 | 3 episodes | 168 vs 221 µmol/L at 2 mo (P = NS) | NA | NA |
Bureau et al[16], 20171 | 27 | After day 7: G1 vs G2: 17 vs 11 episodes; P = NS | G1 vs G2, at 3 mo: Increase of 18.1 vs 8.1 µmol/L (P = NS) | NA | NA |
Stirnimann et al[18], 2017 | 56 | NA | Increase of 46 µmol/L at 3 mo (P = NA) | 5 | 1 |
Solà et al, 2017 | 10 | 18 episodes, 14 after day 7 in 7 patients | 96 vs 105 µmol/L at 12 mo (P = NS) | 3 | 8 |
Solbach et al[17], 2018 | 21 | 0 | 140 vs 168 µmol/L at 3 mo (P = NS) | 11 | 4 |
Wong et al[20], 2020 | 30 | 11 episodes after day 7 in 9 patients | 93 vs 107 µmol/L at 12 mo (P = NA) | 1 | 3 |
Ref. | Patients (n) | Peritoneal catheter dysfunction (n patients) | Bladder catheter dysfunction (n patients) | Pump dysfunction (n patients) | Pump pocket complication (n patients) | Explanted/replaced pumps |
Bellot et al[15], 2013 | 40 | 5 | 9 | 2 | Infection: 2 Wound: 2 | 13/NA |
Thomas et al[20], 2015 | 10 | 0 | Kinking: 1 | 1 | Infection: 1 Wound: 2 | 1/0 |
Bureau et al[16], 2017 | 27 | 2 | 3 | 12 | 3 | 3/4 |
Stirnimann et al[18], 2017 | 56 | Blockage: 13 Displacement: 2 Disconnection: 1 Twist: 2 | Blockage: 1 Migration: 1 | Clogging: 2 Humidity: 2 Communication: 4 Faulty sensor: 3 | Infection: 2 Wound: 2 | 17/11 |
Solà et al[19], 2017 | 10 | Migration: 2 Blockage: 1 | 2 | Charging problem: 2 Transient blockage:2 | 1 | 2/1 |
Karkhanis et al[14], 2017 | 3 | 0 | Migration: 1 | 1 | 2 | |
Solbach et al[17], 2018 | 21 | Obstructions: 6 | Dislocations: 5 | 4 | 4 | 4/2 |
Wong et al[20], 2020 | 30 | 13 | 1 | 3 | 4 | 10/9 |
Will et al[24], 2020 | 40 | NA | Obstructions: 9 | NA | NA | 12/40 |
- Citation: 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
- URL: https://www.wjgnet.com/1948-5182/full/v14/i7/1344.htm
- DOI: https://dx.doi.org/10.4254/wjh.v14.i7.1344