Explore This Treatment 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.

Our Publications

Frequently Asked Questions

How do I make an appointment for this treatment?
The Hepatic Artery Infusion Pump Program at Mass General is led by Motaz Qadan, MD, PhD, liver surgeon, and Elizabeth Paige Walsh, MD, medical oncologist. Patients and referring providers can request an appointment by calling 617-643-5153.
How does hepatic artery infusion work?
A hepatic artery infusion pump, also called a liver chemotherapy pump, is a small pump that is surgically implanted just below the skin in the abdomen and connects with the liver through a small tube inserted into the hepatic artery. Once implanted, heat from the body activates the pump to deliver medicine directly to the tumors in the liver. There are no batteries, motors, or gears that can stall or fail, nor will the pump run out of power.
It works to shrink the size of the liver tumors so that they can be surgically removed in the future and prevent additional spread of the cancer within the liver.
What are the benefits of the hepatic artery pump vs. traditional chemotherapy?
Traditional chemotherapy is administered intravenously and is effective in preventing cancer from occurring elsewhere in your body. However, when injected through the vein, it circulates throughout the whole body and can often become diluted before it reaches the cancer—in this way, only a small portion of the chemotherapy ultimately reaches the tumors in the liver. The hepatic artery pump is designed to inject high, concentrated doses of chemotherapy directly into the liver without it having to circulate elsewhere. This precise, localized delivery mechanism provides a higher concentration of medication to the tumors, limiting potential side effects elsewhere in the body.
Am I eligible for a hepatic artery infusion pump?
Patients with liver tumors, in particular metastatic colorectal liver metastases, without evidence of extrahepatic disease, are eligible for hepatic artery infusion pump treatment. Exclusion criteria typically include the presence of disease elsewhere in the body, as the pump is unable to treat disease outside the liver. However, you should discuss with your surgeon and medical oncologist as there are exceptions.
How often will I need to see my doctor after the pump has been implanted?
The pump will need to be periodically refilled. Patients can expect to visit the doctor’s office every few weeks to refill the pump while receiving therapy. The refill procedure takes about 10-15 minutes.
Do I have to limit my activities during HAI therapy?
Once you have recovered from surgery, you will be able to continue most of the activities you enjoyed before surgery. Your care team will provide you with guidelines specific to your condition and overall health. Some guidelines might include avoiding strenuous physical activity and heating pads that may impact the function of the pump.

Additional Resources

Liver Cancer Treatment

Liver Cancer Treatment

Learn about Mass General Cancer Center’s expert approach to liver cancer treatment.

Liver Surgery

Liver Surgery

Learn about the specialized treatments offered by our liver surgeons.

Preparing for Surgery

Preparing for Surgery

Review information and instructions to help you prepare for your surgery or procedure.

Animation: How It Works

Animation: How It Works

Watch a short animation that explains HAI therapy and how it works in the body.






Nurse Practitioner and Clinical Nurse Specialists

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

Pharmacy

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