Editorial
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jun 21, 2024; 30(23): 2954-2958
Published online Jun 21, 2024. doi: 10.3748/wjg.v30.i23.2954
Advancing hepatic recompensation: Baveno VII criteria and therapeutic innovations in liver cirrhosis management
Lorenzo Ridola, Sara Del Cioppo
Lorenzo Ridola, Sara Del Cioppo, Department of Medical and Surgical Sciences and Biotechnologies, Sapienza University of Rome, Polo Pontino, Rome 00185, Italy
Author contributions: Del Cioppo S was responsible for conceptualization and manuscript writing; Ridola L was responsible for conceptualization, manuscript writing, key revisions of important knowledge content, and final approval.
Conflict-of-interest statement: Lorenzo Ridola and Sara Del Cioppo have nothing to disclose.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Lorenzo Ridola, PhD, Associate Professor, Department of Medical and Surgical Sciences and Biotechnologies, Sapienza University of Rome, Polo Pontino, Viale dell'Università 37, Rome 00185, Italy. lorenzo.ridola@uniroma1.it
Received: March 19, 2024
Revised: May 14, 2024
Accepted: May 22, 2024
Published online: June 21, 2024
Processing time: 93 Days and 6.2 Hours
Abstract

The Baveno VII criteria redefine the management of decompensated liver cirrhosis, introducing the concept of hepatic recompensation marking a significant departure from the conventional view of irreversible decline. Central to this concept is addressing the underlying cause of cirrhosis through tailored therapies, including antivirals and lifestyle modifications. Studies on alcohol, hepatitis C virus, and hepatitis B virus-related cirrhosis demonstrate the efficacy of these interventions in improving liver function and patient outcomes. Transjugular intrahepatic portosystemic shunt (TIPS) emerges as a promising intervention, effectively resolving complications of portal hypertension and facilitating recompensation. However, optimal timing and patient selection for TIPS remain unresolved. Despite challenges, TIPS offers renewed hope for hepatic recompensation, marking a significant advancement in cirrhosis management. Further research is needed to refine its implementation and maximize its benefits. In conclusion, TIPS stands as a promising avenue for improving hepatic function and patient outcomes in decompensated liver cirrhosis within the framework of the Baveno VII criteria.

Keywords: Hepatic recompensation, Baveno VII, Transjugular intrahepatic portosystemic shunt, Portal hypertension, Cirrhosis, Decompensation

Core Tip: The manuscript explores the concept of hepatic recompensation outlined in the Baveno VII criteria, challenging the traditional view of decompensated liver cirrhosis as irreversible. It emphasizes the importance of addressing the underlying cause of cirrhosis, tailoring therapy accordingly, and achieving specific criteria for recompensation. Studies on alcohol, hepatitis C virus and hepatitis B virus-related cirrhosis demonstrate how targeted interventions, including antiviral therapy and Transjugular intrahepatic portosystemic shunt (TIPS) procedures, promote hepatic compensation. While promising, optimal timing and therapy selection for TIPS remain unresolved. Nevertheless, TIPS emerges as a promising avenue for hepatic recompensation, offering renewed hope for patients previously deemed untreatable.