Hepatic artery infusion (HAI) pump

What is a hepatic artery infusion pump?

A hepatic artery infusion (HAI) pump is a medical device used to deliver chemotherapy directly to the liver. About the size of a hockey puck, this pump is typically implanted under the skin between your ribs and pelvis and is connected to the hepatic artery, the main vessel supplying blood to the liver. By delivering chemotherapy directly to the liver, higher concentrations of the drug can target tumors in the liver more effectively while minimizing side effects.

Penn Medicine cancer specialists are national leaders in using HAI pumps to treat metastatic colon cancer, which is cancer that has spread from the colon to the liver, and intrahepatic cholangiocarcinoma, which is cancer that develops in the cells within the bile ducts both inside and outside the liver. We’re the only medical center in the southeastern Pennsylvania and New Jersey regions that treats patients with hepatic artery infusion pumps.

How an HAI pump works

Traditional chemotherapy is given through an IV. As chemotherapy travels through your veins, it becomes diluted, resulting in a relatively low concentration reaching your liver. With a hepatic artery infusion pump, the chemotherapy goes directly into your liver at concentrations that are much higher than IV chemotherapy.

You’ll undergo chemotherapy through the pump for four to six months. Throughout your treatment, you’ll visit the medical center every two weeks for pump refills, typically accompanied by lab tests and IV chemotherapy. A needle is used to drain and refill the pump, taking about 10 minutes.

Who is a candidate for an HAI pump?

Your Penn Medicine provider may recommend a hepatic artery infusion pump if you have one of the following conditions:

Colon cancer that has spread to the liver
Bile duct cancer that starts in the liver, called intrahepatic cholangiocarcinoma

The decision to use an HAI pump is typically made by a multidisciplinary team of oncologists, surgeons, and other specialists. During evaluation, your care team considers factors such as your overall health and the presence of cancer in other parts of your body when determining if an HAI pump is right for you.

What to expect during an HAI pump insertion

Before your HAI pump insertion, your doctor will explain the surgery and allow time for you to ask questions. Your care team will review your medications, discuss your health history, and provide instructions on preparing for the surgery.

On the day of your procedure, you can expect the following:

Anesthesia with sedation will be administered to induce sleep and ensure you remain pain-free throughout the surgery.
Your surgeon will make an incision, usually in the abdomen, to access the blood vessels leading to the liver.
The HAI pump is implanted under the skin and connected to the hepatic artery.
A thin tube called a catheter is threaded from the pump into the hepatic artery. This allows for direct delivery of chemotherapy drugs into the bloodstream feeding the liver.
After ensuring the pump and catheter are properly positioned and functioning, the surgical incision is closed with stitches or staples.
You’ll be monitored closely after the procedure to manage pain and watch for any immediate complications.
Most patients stay in the hospital for a few days for observation and initial adjustments to the pump.

Recovering from an HAI pump insertion

Recovery is different for everyone, but many patients resume normal activities within a few weeks. Regular follow-up appointments will be scheduled to monitor the pump’s function, adjust chemotherapy doses, and manage any side effects. Our team is by your side through every stage of treatment and recovery.

The chemo pump stays in place for six months to several years if ongoing treatment is required. When not being treated with chemotherapy, we’ll refill the pump with a drug-free liquid every six weeks to maintain its functionality. When it’s time for HAI pump removal, you’ll undergo an outpatient procedure performed by your cancer surgeon. The catheter connected to your hepatic artery will remain in place permanently.

Experts in HAI pump treatment and recovery at Penn

Our doctors specialize in hepatic artery infusion pump insertion and care, ensuring you benefit from a team with extensive experience capable of tailoring treatment to your unique requirements. The team includes:

Oncologists skilled in administering chemotherapy doses via HAI pumps to treat your specific cancer.
Surgeons with experience placing HAI pumps.
Dedicated interventional radiologists trained in procedures to ensure your HAI pump is working properly.

Each provider uses the latest research findings to give you the best result.

National Cancer Institute Designated Comprehensive Cancer Center badge on top of shot of hospital

Rated “exceptional” by The National Cancer Institute

Penn Medicine’s Abramson Cancer Center is a world leader in cancer research, patient care, and education. Our status as a national leader in cancer care is reflected in our continuous designation as a Comprehensive Cancer Center by the National Cancer Institute (NCI) since 1973, one of 7 such centers in the United States. The ACC is also a member of the National Comprehensive Cancer Network, one of a select few cancer centers in the U.S., that are working to promote equitable access to high-quality, advanced cancer care.