alfapump® for ascites control

Living with cirrhosis and ongoing fluid buildup in the belly (ascites) often means repeated hospitalizations for paracentesis, an invasive procedure to remove that fluid. The automated low-flow ascites pump (alfapump®) offers a new way to manage ascites. This small, battery-powered device is placed under the skin and automatically moves fluid from the abdomen into the bladder, where it’s passed naturally when you urinate. Because the pump works continuously, many people notice their stomach stays flatter, making it easier to eat, breathe, sleep, and return to normal daily activities.

Alfapump implantation is performed by specially trained liver and interventional radiology specialists. Penn Medicine is one of the few centers in the nation offering this breakthrough therapeutic option. At our dedicated Ascites Clinic, liver disease care specialists provide comprehensive treatment options for people with ascites.

The alfapump system is designed for adults with liver cirrhosis and severe fluid buildup (refractory ascites) that continues despite standard treatments. In some cases, options like diuretics (water pills), a low-salt diet, or repeated paracentesis may no longer work well or may be difficult for your body to tolerate. If these excess abdominal fluid treatments aren’t helping and the fluid keeps returning, you may be a candidate for the alfapump procedure.

Because this device isn’t safe for use with MRI machines and may interact with other medical therapies like radiation, it’s important that you talk with your provider to discuss your specific medical history and decide if this treatment is right for you.

To place the alfapump, doctors use a minimally invasive procedure, often done through interventional radiology techniques. This approach relies on small incisions and imaging guidance like ultrasound to place the device safely and precisely. Depending on your health needs, this may be done under conscious sedation, local anesthesia, or general anesthesia.

During the procedure, the small pump is placed just under the skin on your abdomen. Two soft tubes (catheters) are then connected to the pump and positioned inside your body. One tube collects fluid from your abdominal cavity, and another tube in your bladder moves fluid out. The entire alfapump system is fully internal, with no external tubes or ports. Once implanted, the pump is programmed to remove the right amount of fluid each day and at times that are convenient to avoid nighttime urination. The procedure usually takes around an hour, and most people are able to go home the following day.

Recovery after the alfapump implantation is usually quick. You may feel soreness at the incision sites for a few days, but most people can return to light activities soon after going home. Before you leave the hospital, your care team will teach you how to charge the device wirelessly through your skin using a small handheld charger. The charger comes with a docking station that keeps it ready to use, making daily charging simple. This becomes part of your daily routine. Many people charge the pump while reading or watching TV. The system works quietly in the background, automatically moving fluid throughout the day. Your provider can monitor the device remotely and adjust its settings as needed.

At Penn Medicine, our goal is to improve quality of life and deliver consistent, evidence-based care for those with advanced liver disease. At our Ascites Clinic, you’ll find a coordinated team of experts, including liver specialists, dietitians, interventional radiologists, and others all working together to deliver consistent care. The clinic provides a full range of options, including diuretic adjustment, dietary guidance, large-volume paracentesis, TIPS evaluation, and access to innovative treatments like the alfapump system.