New Implant Frees Liver Patients from Weekly Procedures

Imagine needing to visit the hospital every single week to have up to ten liters of fluid drained from your abdomen through a painful procedure. For patients with end-stage liver disease, this exhausting routine has been the only option for managing severe fluid buildup called ascites.

That changed when Dartmouth Hitchcock Medical Center became the first non-transplant center in the United States to implant the alfapump, a pacemaker-sized device that automatically drains excess fluid. The pump routes fluid from the abdomen into the bladder, where patients eliminate it naturally through urination.

Dr. Thomas Burdick, an interventional radiologist, watched his patients struggle for years with the old treatment. They'd arrive uncomfortable and bloated, endure an invasive drainage procedure, feel better for a few days, then watch their symptoms return as fluid built up again.

"We have patients who will get five to ten liters of fluid removed every week," Burdick says. Between constant discomfort and frequent medical appointments, quality of life plummeted for people who couldn't access liver transplants due to organ shortages.

The FDA approved the alfapump in late 2024, but the manufacturer initially focused on transplant centers. Burdick reached out directly, convincing them that patients at smaller facilities desperately needed this technology too.

Dartmouth Hitchcock took a financial risk to offer the treatment, which costs about $50,000 and isn't yet covered by insurance. They became one of just five initial U.S. implant sites.

The device recharges wirelessly through the skin, like a phone on a charging pad. It's programmable to avoid interrupting sleep with nighttime bathroom trips.

The Ripple Effect

The first patient to receive the device hasn't needed a single drainage procedure since implantation. His transformation shows how one medical advance can restore independence to people trapped in exhausting treatment cycles.

Burdick and his hepatology colleagues now estimate 10 to 12 Dartmouth Health patients could benefit annually at first, with expansion planned as doctors gain comfort with the procedure. The technology may eventually help patients earlier in their disease process, not just the sickest cases.

By bringing this treatment to northern New England, a determined medical team proved that cutting-edge care doesn't have to wait for the biggest medical centers. Sometimes innovation happens when one doctor refuses to accept that suffering is inevitable.