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 Gomes 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, Joan Genesca, Rafael Bañares, Terry Cheuk-Fung Yip, L. Tellez, Emmanuel Tsochatzis, Annalisa Berzigotti, Hélène Larrue, Horia Ştefănescu, P Caraceni, Elisa Pose, Dalila Costa, Benjamin Maasoumy, Salvatore Piano, Thomas Reiberger · 发表于：Open Access CRIS of the University of Bern · 年份：2026 · DOI：10.48620/94211 · 研究领域：Alcohol Consumption and Health Effects、Alcoholism and Thiamine Deficiency、Liver Disease and Transplantation

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 at time of abstinence until 12/2022. 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 one year, and (iv) restored liver function (Child-Pugh A or MELD <10).Results 633 patients from 17 centres were included (71.7% male; 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; aSHR:2.042), higher aspartate transaminase (aSHR /10 U/L:1.011) and gamma-glutamyltransferase (aSHR /10 U/L:1.004) (all p<0.001) increased recompensation likelihood in both supervised and machine-learning models, while the presence of further decompensation decreased it (aSHR:0.650, p=0.013). 123 patients died during follow-up (...