{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,14]],"date-time":"2026-03-14T14:01:26Z","timestamp":1773496886517,"version":"3.50.1"},"reference-count":24,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2022,7,25]],"date-time":"2022-07-25T00:00:00Z","timestamp":1658707200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Liver International"],"published-print":{"date-parts":[[2022,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and aims<\/jats:title><jats:p>Patients with cirrhotic refractory ascites ineligible for transjugular intrahepatic shunt (TIPSS) have limited treatment options apart from repeated large volume paracentesis. The alfapump\u00ae is an implantable device mobilizing ascites from the peritoneal cavity to the bladder, from where it can be excreted. The aim of this observational cohort study was to prospectively investigate safety and efficacy of the device in a real\u2010world cohort with cirrhotic refractory ascites and contraindications for TIPSS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 106 patients received an implant at 12 European centres and were followed up for up to 24\u2009months. Complications, device deficiencies, frequency of paracentesis, clinical status and survival were recorded prospectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Approximately half of the patients died on\u2010study, about a quarter was withdrawn because of serious adverse events leading to explant, a sixth were withdrawn because of liver transplant or recovery, and nine completed follow\u2010up. The most frequent causes of on\u2010study death and complication\u2010related explant were progression of liver disease and infection. The device reduced the requirement for large\u2010volume paracentesis significantly, with more than half of patients not having required any post\u2010implant. Survival benefits were not observed. Device\u2010related reinterventions were predominantly caused by device deficiencies. A post\u2010hoc comparison of the first 50 versus the last 50 patients enrolled revealed a decreased reintervention rate in the latter, mainly related to peritoneal catheter modifications.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The device reduced paracentesis frequency in a real\u2010world setting. Technical complications were successfully decreased by optimization of management and device modification (NCT01532427).<\/jats:p><\/jats:sec>","DOI":"10.1111\/liv.15337","type":"journal-article","created":{"date-parts":[[2022,6,10]],"date-time":"2022-06-10T11:24:08Z","timestamp":1654860248000},"page":"2247-2259","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Final safety and efficacy results from a 106 real\u2010world patients registry with an ascites\u2010mobilizing pump"],"prefix":"10.1111","volume":"42","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3447-264X","authenticated-orcid":false,"given":"Guido","family":"Stirnimann","sequence":"first","affiliation":[{"name":"University Clinic for Visceral Surgery and Medicine, Inselspital University Hospital University of Bern  Bern 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Bern Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4887-5776","authenticated-orcid":false,"given":"Vanessa","family":"Banz","sequence":"additional","affiliation":[{"name":"University Clinic for Visceral Surgery and Medicine, Inselspital University Hospital University of Bern  Bern Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jana","family":"Babatz","sequence":"additional","affiliation":[{"name":"Medizinische Klinik I Universit\u00e4tsklinikum Carl Gustav Carus  Dresden Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Victor","family":"Vargas","sequence":"additional","affiliation":[{"name":"Liver Unit, Hospital Vall d'Hebron Universitat Aut\u00f2noma Barcelona, CIBERehd  Barcelona Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andreas","family":"Geier","sequence":"additional","affiliation":[{"name":"Division of Hepatology, Department of Medicine 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