{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T10:59:45Z","timestamp":1792839585901,"version":"4.5.0"},"reference-count":29,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2019,10,3]],"date-time":"2019-10-03T00:00:00Z","timestamp":1570060800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Aliment Pharmacol Ther"],"published-print":{"date-parts":[[2019,11]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Few effective treatments are available for patients with cirrhosis and refractory ascites. New treatment modalities are needed for\u00a0these patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>To synthesise the available evidence on the efficacy and safety of automated low\u2010flow ascites pump therapy in patients with cirrhosis and refractory ascites.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Electronic databases were searched for trials evaluating automated low\u2010flow ascites pump therapy in patients with refractory ascites.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Nine studies were included. Eight were case series, one was a randomised controlled trial. Pooled estimate rates were 0.62 (95% CI\u00a0=\u00a00.49\u20100.74) for the absence of requirement of large volume paracentesis (LVP) after pump insertion, 0.30 (95% CI\u00a0=\u00a00.17\u20100.47) for acute kidney injury, 0.27 (95% CI\u00a0=\u00a00.13\u20100.49) for bacterial peritonitis and 0.20 (95% CI\u00a0=\u00a00.09\u20100.37) for urinary tract infection. There was high heterogeneity between studies which was often reduced or eliminated in sensitivity analyses by excluding studies of patients with a mean or median model for end\u2010stage liver disease (MELD) score\u00a0&gt;\u00a015. Results of sensitivity analyses were similar to those of overall analyses. Mean increase in serum creatinine level after pump insertion was 23\u00a0\u00b5mol\/L (95% CI\u00a0=\u00a010\u201035) with no heterogeneity between studies. The pooled estimate rate for pump\u2010related side effects was 0.77 (95% CI\u00a0=\u00a00.64\u20100.87) with low heterogeneity between studies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This meta\u2010analysis demonstrates that most patients treated with automated low\u2010flow ascites pump therapy do not require LVP after pump insertion. Acute kidney injury occurs in 30% of patients and creatinine levels increase by a mean of 23\u00a0\u00b5mol\/L after pump insertion. Bacterial peritonitis and urinary tract infection occur in 27% and 20% of patients respectively.<\/jats:p><\/jats:sec>","DOI":"10.1111\/apt.15502","type":"journal-article","created":{"date-parts":[[2019,10,4]],"date-time":"2019-10-04T01:44:31Z","timestamp":1570153471000},"page":"978-987","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":33,"title":["Systematic review with meta\u2010analysis: automated low\u2010flow ascites pump therapy for refractory ascites"],"prefix":"10.1111","volume":"50","author":[{"given":"Antonia","family":"Lepida","sequence":"first","affiliation":[{"name":"Department of Gastroenterology, Hepatopancreatology, and Digestive Oncology CUB H\u00f4pital Erasme Universit\u00e9 Libre de Bruxelles Brussels Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Astrid","family":"Marot","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology CHU UCL Namur Universit\u00e9 Catholique de Louvain Yvoir Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric","family":"Tr\u00e9po","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Hepatopancreatology, and Digestive Oncology CUB H\u00f4pital Erasme Universit\u00e9 Libre de Bruxelles Brussels Belgium"},{"name":"Laboratory of Experimental Gastroenterology Universit\u00e9 Libre de Bruxelles Brussels Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Delphine","family":"Degr\u00e9","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Hepatopancreatology, and Digestive Oncology CUB H\u00f4pital Erasme Universit\u00e9 Libre de Bruxelles Brussels Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christophe","family":"Moreno","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Hepatopancreatology, and Digestive Oncology CUB H\u00f4pital Erasme Universit\u00e9 Libre de Bruxelles Brussels Belgium"},{"name":"Laboratory of Experimental Gastroenterology Universit\u00e9 Libre de Bruxelles Brussels Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4253-6028","authenticated-orcid":false,"given":"Pierre","family":"Deltenre","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Hepatopancreatology, and Digestive Oncology CUB H\u00f4pital Erasme Universit\u00e9 Libre de Bruxelles Brussels Belgium"},{"name":"Department of Gastroenterology and Hepatology Clinique St Luc Bouge Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,10,3]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2018.03.024"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2007.06.020"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1478-3231.2005.01095.x"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2016.09.016"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2012.12.020"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2017.06.010"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/MEG.0000000000000403"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/apt.13424"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/liv.13318"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2036.2012.05197.x"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.b2535"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/lt.24763"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2015.05.022"},{"key":"e_1_2_7_15_1","unstructured":"National Heart LaBI.Quality assessment tool for case series studies.https:\/\/www.nhlbi.nih.gov\/health-pro\/guidelines\/in-develop\/cardiovascular-risk-reduction\/tools\/case_series. Accessed ???"},{"key":"e_1_2_7_16_1","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1002\/9780470743386","volume-title":"Introduction to Meta\u2010Analysis","author":"Borenstein MI","year":"2009"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/0197-2456(86)90046-2"},{"key":"e_1_2_7_18_1","first-page":"285","volume-title":"Systematic Reviews in Health Care\u2010Meta\u2010Analysis in Context","author":"Deeks JJ","year":"2005"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/sim.1186"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.2307\/2533446"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1259\/bjrcr.20170025"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1097\/MEG.0000000000001149"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/apt.14331"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00423-015-1356-1"},{"issue":"1","key":"e_1_2_7_25_1","first-page":"561A","article-title":"Long\u2010term follow\u2010up of patients with cirrhosis and recurrent ascites treated with an automatic low flow ascites pump (alfapump) in North America","volume":"68","author":"Wong F","year":"2018","journal-title":"Hepatology"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2015-309861.589"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2036.2003.01664.x"},{"key":"e_1_2_7_28_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2036.2012.05088.x"},{"key":"e_1_2_7_29_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11136-018-1813-8"},{"key":"e_1_2_7_30_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.316.7125.140"}],"container-title":["Alimentary Pharmacology &amp; Therapeutics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fapt.15502","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/apt.15502","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,7]],"date-time":"2023-09-07T00:49:20Z","timestamp":1694047760000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/apt.15502"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,10,3]]},"references-count":29,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2019,11]]}},"alternative-id":["10.1111\/apt.15502"],"URL":"https:\/\/doi.org\/10.1111\/apt.15502","archive":["Portico"],"relation":{},"ISSN":["0269-2813","1365-2036"],"issn-type":[{"value":"0269-2813","type":"print"},{"value":"1365-2036","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,10,3]]},"assertion":[{"value":"2019-05-16","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-08-23","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-10-03","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}