Validation and expansion of Baveno VII recompensation criteria in patients with cirrhosis and curable liver disease

作者：Marta Tonon, Roberta Gagliardi, Enrico Pompili, Anna Barone, Giacomo Zaccherini, Gianluca Zilio, Maurizio Baldassarre, Antônio Carlos Accetta, Daniele Carrello, Valeria Calvino, Giulia Iannone, Simone Incicco, N. Zeni, Carmine Gambino, Paolo Caraceni, Paolo Angeli, Salvatore Piano · 发表于：Journal of Hepatology · 年份：2025 · DOI：10.1016/j.jhep.2025.04.018 · 被引用次数：42 · 研究领域：Liver Disease and Transplantation、Organ Transplantation Techniques and Outcomes、Sepsis Diagnosis and Treatment

BACKGROUND & AIMS: The Baveno VII group recently proposed criteria to define recompensation in patients with decompensated cirrhosis achieving etiological cure. However, the incidence, predictors and clinical significance of recompensation are poorly understood. The aim of this study was to evaluate the incidence and prognostic impact of recompensation in patients with decompensated cirrhosis. METHODS: Outpatients with cirrhosis and curable etiologies (alcohol, HCV, HBV) were consecutively included and followed up. Recompensation was defined according to Baveno VII criteria. Additionally, expanded recompensation criteria were evaluated for patients on low-dose diuretics and/or lactulose/rifaximin for ≥12 months. In 160 patients, inflammatory cytokines (IL-6, IL-1β, IL-10) were measured in serum samples. An external cohort was used to validate study findings. RESULTS: Out of 525 outpatients with decompensated cirrhosis, 298 received effective etiological treatment and 21 (7%) achieved recompensation (Baveno VII criteria), while 112 patients achieved expanded recompensation criteria (37.6%). MELD score (subdistribution hazard ratio [sHR] 0.89; p <0.001), BMI (sHR 0.93; p = 0.020), hemoglobin (sHR 1.14; p = 0.010) and further decompensation (sHR 0.50; p = 0.001) were independent predictors of recompensation. In multivariable analysis, mortality risk was not significantly different between patients achieving recompensation and compensated patients (HR 0.97; p = 0.947), while deco...