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Article Abstract
Background & Aims: The prevalence and clinical outcomes of recompensation in patients with decompensated cirrhosis remain unclear. We aimed to determine the prevalence and clinical outcomes among decompensated patients who achieve recompensation.
Methods: We systematically searched PubMed and EMBASE from inception until 15 July 2025. We included studies reporting on decompensated cirrhosis patients achieving recompensation to evaluate the clinical outcomes, specifically hepatocellular carcinoma (HCC), death, liver-related death, and liver transplantation, with those who did not recompensate.
Results: A total of 27 studies encompassing 9,063 patients with decompensated cirrhosis were analysed. The overall pooled prevalence of recompensation was 35% (95% CI: 26%-45%, I=98%, 24 studies). Recompensation was most common in HBV-related cirrhosis (50%; 95%CI: 38-61%, I=99%, 8 studies) and least common in primary biliary cholangitis-related cirrhosis (15%; 95%CI: 4-30%, I=92%, 3 studies). Low certainly evidence suggest that recompensated patients had significantly lower odds of HCC occurrence (OR: 0.55; 95% CI: 0.35-0.87, I=12%, 7 studies), death (OR: 0.33, 95% CI: 0.19-0.58, I=52%, 9 studies), and liver-related death (OR: 0.21, 95% CI: 0.10-0.45, I=36%, 9 studies), with similar odds of liver transplantation (OR: 0.34, 95% CI: 0.07-1.60, I=0%, 3 studies).
Conclusion: Recompensation occurred in approximately one-third of decompensated cirrhosis patients who achieved etiological control. Recompensation was associated with lower risk of HCC and death, thus represents a clinically meaningful endpoint in this population.
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| http://dx.doi.org/10.1016/j.cgh.2025.08.010 | DOI Listing |
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