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

作者：B. Hofer, M. Tonon, L. Buttler, J. Camões Neves, Q. Herms, E. Pompili, M. Ignat, S. Métivier, S. Gomes Rodrigues, Daniel Gutmann, J. Donate, Jimmy Che-To Lai, Ana Clemente Sánchez, A. Jiménez-Masip, Josune Cabello, C. Bouzbib, Henrik Karbannek, Jan Embacher, T. Sorz-Nechay, Lukas Parandian, A. Accetta, R. Gagliardi, M. Griemsmann, J. Gratacós-Ginés, M. Mandorfer, Guadalupe Garcia-Tsao, Douglas A. Simonetto, G. Semmler, A. Zipprich, M. Rudler, J. Trebicka, Joan Genescà, R. Bañares, Terry Cheuk-Fung Yip, Luis Téllez, Emmanuel A. Tsochatzis, A. Berzigotti, H. Larrue, Horia Ștefănescu, P. Caraceni, Elisa Pose, Dalila Costa, B. Maasoumy, Salvatore Piano, T. Reiberger · 发表于：Journal of Hepatology · 年份：2026 · DOI：10.1016/j.jhep.2026.01.007 · 被引用次数：11 · 研究领域：Medicine

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 follo...