1 Recommendations

1 Recommendations

1.1 Current evidence on the safety of subcutaneous automated low-flow pump implantation for refractory ascites shows there are serious but well-recognised safety concerns, including device failure and acute kidney injury. Evidence on efficacy is limited in quantity. Therefore, this procedure should only be used with special arrangements for clinical governance, consent, and audit or research. Find out what special arrangements mean on the NICE interventional procedures guidance page.

1.2 Clinicians wishing to do subcutaneous automated low-flow pump implantation for refractory ascites should:

1.3 All device failures should be reported to the Medicines and Healthcare products Regulatory Agency.

1.4 Patient selection should be done in specialist centres, by clinicians experienced in managing liver disease and in the various options available for managing ascites.

1.5 Further research should report details of patient selection, the frequency of pump-related complications, and the need for regular albumin infusions.

  • National Institute for Health and Care Excellence (NICE)