Patients with end-stage liver disease, RA, and contraindications for TIPS are difficult to treat and have frequent complications.13,21 To enable a more self-determined life and to save costs from repeated LVP in combination with albumin infusion, devices like PeCa or Alfapump have been introduced.22 However, little is known about the association of daily low-volume ascites taps, and this distinct group represents a new entity of patients. Here, ALB is linked to End Stage Liver Disease.