Zhang JS. Hepatic recompensation according to the Baveno VII criteria via a transjugular intrahepatic portosystemic shunt: Is this true? World J Gastrointest Surg 2024; 16(8): 2742-2744 [PMID: 39220088 DOI: 10.4240/wjgs.v16.i8.2742]
Corresponding Author of This Article
Jin-Shan Zhang, MD, Chief Doctor, Surgeon, Department of General Surgery, Capital Institute of Pediatrics, No. 2 Yabao Road, Chaoyang District, Beijing 100020, China. zjs851@163.com
Research Domain of This Article
Surgery
Article-Type of This Article
Letter to the Editor
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (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: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Surg. Aug 27, 2024; 16(8): 2742-2744 Published online Aug 27, 2024. doi: 10.4240/wjgs.v16.i8.2742
Hepatic recompensation according to the Baveno VII criteria via a transjugular intrahepatic portosystemic shunt: Is this true?
Jin-Shan Zhang
Jin-Shan Zhang, Department of General Surgery, Capital Institute of Pediatrics, Beijing 100020, China
Author contributions: Zhang JS contributed to this paper; Zhang JS designed the overall concept and outline of the manuscript; Zhang JS contributed to the discussion and design of the manuscript; Zhang JS contributed to the writing, and editing the manuscript, illustrations, and review of literature.
Supported byNational Natural Science Foundation of China, No. 82170679; and Beijing Physician Scientist Training Project, China, No. BJPSTP-2024-28.
Conflict-of-interest statement: The author has no conflicts of interest 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: Jin-Shan Zhang, MD, Chief Doctor, Surgeon, Department of General Surgery, Capital Institute of Pediatrics, No. 2 Yabao Road, Chaoyang District, Beijing 100020, China. zjs851@163.com
Received: February 21, 2024 Revised: July 10, 2024 Accepted: July 15, 2024 Published online: August 27, 2024 Processing time: 177 Days and 7.4 Hours
Abstract
Hepatic recompensation is firstly described in the Baveno VII criteria, which requires the fulfillment of strict criteria. First, a primary cause of cirrhosis must be addressed, suppressed, or cured. Second, complications of liver cirrhosis, including ascites, encephalopathy, and variceal hemorrhage, must disappear without any intervention. Finally, liver function indicators must be improved. Moreover, without addressing/suppressing/curing cirrhosis and improvement in liver synthetic function, complications, including ascites and variceal hemorrhage can be improved by a transjugular intrahepatic portosystemic shunt (TIPS), which is not evidence of hepatic recompensation. Therefore, on the basis of the definition of hepatic recompensation, TIPS does not achieve hepatic recompensation.
Core Tip: The transjugular intrahepatic portosystemic shunt (TIPS) procedure is currently the most widely used method for treating cirrhotic portal hypertension and is known for causing minimal trauma and having satisfactory results. However, the TIPS procedure is not a perfect treatment. There are increased risks of shunt dysfunction and encephalopathy after TIPS. A TIPS functions as a side-to-side portocaval shunt and promptly reduces portal pressure. In conclusion, TIPSs cannot achieve hepatic recompensation, although they are effective in decreasing the incidence of complications caused by portal hypertension. Hepatic recompensation can be achieved by addressing, suppressing, or curing cirrhosis.
