Sharma Sanchit, Roy Akash
Translational Gastroenterology Unit, John Radcliffe Hospital, Oxford, OX39DU, United Kingdom.
Institute of Gastrosciences and Liver Transplantation, Apollo Multispeciality Hospitals, Kolkata, 700054, India.
J Clin Exp Hepatol. 2023 Mar-Apr;13(2):329-334. doi: 10.1016/j.jceh.2022.08.002. Epub 2022 Aug 18.
The natural history of cirrhosis has usually been conceptualized in the context of progression from compensated cirrhosis to subsequent stages of decompensation. While this unidirectional concept is the most common pathophysiological trajectory, there has been an emerging understanding of a subgroup of patients which undergo recompensation. While literature mostly based on transplant waitlist registries have indicated towards such a population who experience disease regression, the overall literature about this entity remains inexplicit. An effort to generate consensus on defining recompensation has been attempted which comes with its own nuances and limitations. We summarize the available literature on this emerging yet controversial concept of recompensation in cirrhosis and delve into future implications and impact on real-life practice.
肝硬化的自然病程通常被认为是从代偿期肝硬化进展到失代偿的后续阶段。虽然这种单向概念是最常见的病理生理轨迹,但人们对一部分经历病情好转的患者群体有了新的认识。虽然大多基于移植等待名单登记处的文献表明存在这样一类病情出现逆转的人群,但关于这一实体的整体文献仍不明确。人们曾试图就代偿好转的定义达成共识,但这一过程有其自身的细微差别和局限性。我们总结了关于肝硬化中这一新兴但有争议的代偿好转概念的现有文献,并深入探讨其对未来的影响以及对实际临床实践的作用。