Hepatic Artery Infusion Pump Program

About the Hepatic Artery Infusion Pump Program

The Hepatic Artery Infusion (HAI) Pump Program at Massachusetts General Hospital is a highly specialized, multidisciplinary collaboration that uses hepatic artery pumps (also known as liver chemotherapy pumps) to treat primary and metastatic tumors of the liver. The pumps are mainly used to treat unresectable, metastatic colorectal liver cancer (cancer that has spread from the colon to the liver).

Mass General is the only hospital in the region that offers hepatic artery infusion pumps as a treatment approach for liver cancer.

The hepatic artery infusion pumps are managed by a multidisciplinary team including:

• Surgeons who are specially trained to place the pump into the liver, safely and effectively
• Medical oncologists from the Mass General Cancer Center who are experts in using the pumps to administer chemotherapy
• Radiologists, including interventional radiologists and nuclear medicine doctors, who evaluate the pump for safe use and ensure that the chemotherapy is delivered only to the liver
• A multitude of highly specialized nurses and staff including infusion nurses, floor nurses, operating room staff and recovery nurses, anesthesia doctors, and pharmacy staff

Hepatic Artery Infusion Pump Treatment

When colorectal cancer metastasizes (spreads throughout the body), it frequently results in liver tumors. Patients with primary or metastatic tumors that cannot be removed because of their location or size (unresectable tumors) may be able to undergo hepatic artery infusion pump placement, which infuses high doses of chemotherapy directly into the liver to shrink them to the point that they can be surgically resected. These pumps allow for the chemotherapy (Floxuridine) to specifically target the tumor through the hepatic artery, a blood vessel that goes to the liver, so that medication remains in the liver and does not spill out to other organs in the body. The healthy parts of the liver continue to receive the blood supply from a separate blood vessel, the portal vein, which is not impacted by HAI therapy.

Treatment with HAI therapy can also be used after liver surgery as a way to prevent recurrence of cancer within the liver.

Mass General surgeons surgically place the pump into the abdominal wall and insert a small, flexible tube into the hepatic artery to transfer high doses of chemotherapy directly into the liver and target the tumors.

Hepatic Artery Infusion Pump Vs. Traditional Chemotherapy

Traditional chemotherapy methods inject medication by vein (intravenously), which causes it to circulate throughout the entire body before it reaches the cancer. With the hepatic artery pump, a much higher and more concentrated amount is administered directly into the cancerous area where it is rapidly metabolized, resulting in limited toxicity to the rest of the body. These treatments can be used simultaneously in centers of excellence and expertise, such as Mass General Cancer Center.

The pump is effective in:

• Shrinking large tumors so that they can be surgically removed in the future
• Delaying or preventing the growth of additional tumors in the liver

Recovery After Hepatic Artery Infusion Pump Placement

The hepatic artery pump is surgically placed in an inpatient procedure that can last up to three hours. A specialized nuclear medicine scan ensures that the pump is placed in the appropriate position to prevent chemotherapy from traveling to organs outside of the liver (extrahepatic perfusion).

Patients can expect to recover at the hospital for a few days after surgery, where they will be cared for by the perioperative care team. At home, only light activity is recommended, as it may take an additional four weeks to fully recover from surgery. The pump is designed to release medication at a set rate for a period of time.

Patients can expect to return to the hospital for recurring follow-up visits to assess the progress of their condition, refill and flush their pump, and further discuss the treatment plan. The timeline for follow-up visits is determined by the specialized care team.

Improving Outcomes for Liver Cancer

As an academic medical center, Mass General invests in research and clinical trials to better understand liver diseases and develop innovative approaches to prevention and treatment. Notably, Mass General participates in a national consortium called the U.S. HAI Consortium that leads collaborative studies to demonstrate the hepatic artery infusion pump’s effectiveness, improve upon the procedure and its outcomes, and increase access for qualifying patients to receive care.

Frequently Asked Questions

Nurse Practitioner and Clinical Nurse Specialists

• Christian Baglini, NP
• Andrea Hansen, RN
• Kendra Connelly, RN

Pharmacy

• Christina Chio, PharmD, BCOP 
• Karie LaFleur, PharmD
• Katharine Hanger, PharmD