Recompensation Following Alcohol-Related Hepatitis Is Associated With Increased Survival: Results From a Multicenter...

Area of Science:

• Hepatology
• Gastroenterology
• Clinical Medicine

Background:

• The rate of recompensation in alcohol-related hepatitis (AH) survivors is not well-established.
• Understanding recompensation is crucial for managing AH and its long-term consequences.

Purpose of the Study:

• To determine the rate and predictors of recompensation in AH survivors.
• To assess the clinical impact of recompensation on transplant-free survival (TFS).
• To develop adapted criteria for recompensation in AH.

Main Methods:

• A nationwide registry-based study of AH patients discharged between 2014 and 2021.
• Recompensation assessed using Baveno VII and expanded AH liberal-abstinence criteria at 1 and 3 years.
• Landmark analysis evaluated the impact of recompensation on TFS.

Main Results:

• Recompensation rates at 3 years were 14.3% (AH liberal-abstinence) and 8.8% (Baveno VII).
• Absence of prior decompensation, higher baseline alkaline phosphatase, and lower Child-Pugh score predicted recompensation.
• Recompensated patients had significantly higher 5-year TFS (84.9% vs. 47.7%).

Conclusions:

• Recompensation is frequent in AH survivors, particularly with alcohol abstinence.
• Recompensation is a significant predictor of improved long-term survival.
• Identifying patients likely to recompense can inform clinical decisions, including liver transplantation eligibility.