Abstinence in Decompensated Alcohol-Related Cirrhosis: The Sooner, The Better

In patients with cirrhosis, the first decompensation is often considered a “point of no return,” but increasing evidence suggests liver disease can “recompensate” upon treatment for its cause. Hepatic recompensation — defined as removal of the cause of cirrhosis, resolution of decompensating events, and stable improvement in liver function (to Child-Pugh A or Model for End-Stage Liver Disease [MELD] <10) — is well-described in viral hepatitis but less studied in alcohol-related cirrhosis.

This multinational retrospective study followed ≈600 patients with decompensated alcohol-related cirrhosis (72% men; median MELD, 19; median age, 55) after they achieved abstinence from alcohol.