Incidence and implications of abstinence-induced recompensation in alcohol-related cirrhosis

作者：Benedikt Hofer, M. Tonon, Laura Buttler, Joana Camões Neves, Queralt Herms, Enrico Pompili, Mina Ignat, Sophie Métivier, Susana Rodrigues, Daniel Gutmann, Jesús Donate, Jimmy Che‐To Lai, Ana Clemente Sánchez, Alba Jiménez-Masip, Josune Cabello, Charlotte Bouzbib, Henrik Karbannek, Jan Embacher, Thomas Sorz, Lukas Parandian, Antonio Accetta, Roberta Gagliardi, Marie Griemsmann, Jordi Gratacós-Ginès, Mattias Mandorfer, Guadalupe Garcia-Tsao, Douglas A. Simonetto, Georg Semmler, Alexander Zipprich, Marika Rudler, Jonel Trebicka, Genescà Joan, Rafael Bañares, Terry Cheuk-Fung Yip, L. Tellez, Emmanuel Tsochatzis, Annalisa Berzigotti, Hélène Larrue, Horia Stefanescu, P Caraceni, Elisa Pose, D A A Costa, Benjamin Maasoumy, Salvatore Piano, Thomas Reiberger, Michael Trauner, Andreas Stallmach, Agustín Albillos · 发表于：Journal of Hepatology · 年份：2026 · DOI：10.1016/j.jhep.2026.01.007 · 被引用次数：12 · 研究领域：Alcohol Consumption and Health Effects、Liver Disease and Transplantation、Alcoholism and Thiamine Deficiency

BACKGROUND & AIMS: Alcohol abstinence enables hepatic recompensation in patients with decompensated alcohol-related cirrhosis. This study investigated the incidence, predictors, and impact of abstinence-induced recompensation. METHODS: This multicentre study included patients with decompensated alcohol-related cirrhosis recruited at the time of abstinence up to December 2022. Recompensation was defined by Baveno VII criteria: (i) sustained abstinence (≥3 months), (ii) resolution of ascites and hepatic encephalopathy off therapy, (iii) absence of variceal bleeding for 1 year, and (iv) restored liver function (Child-Pugh A or MELD <10). RESULTS: A total of 633 patients from 17 centres were included (71.7% male; median age 55 years). Alcohol-associated hepatitis superimposed on cirrhosis was present in 40.8%. Median MELD was 19 (13-24), and 47.2% had progressed to further decompensation at abstinence. Median time from index decompensation to abstinence was 0.2 (0.0-7.6) months. Over a follow-up of 36.3 (19.2-63.2) months, 197 patients (31.1%) achieved recompensation (cumulative incidence: 12.3% at 1 year, 23.4% at 2 years, 33.8% at 5 years). Early abstinence (within 1 month of decompensation; adjusted subdistribution hazard ratio [aSHR] 2.042), higher aspartate aminotransferase (aSHR per 10 U/L increase: 1.011) and gamma-glutamyltransferase (aSHR per 10 U/L increase: 1.004) (all p <0.001) increased recompensation likelihood in both supervised and machine-learning models, while t...