据描述，再补偿可以改善肝硬化患者的预后。然而，经颈静脉肝内门体分流术（TIPS）后的再代偿尚未进行研究。我们评估了 TIPS 后的再补偿对肝细胞癌 (HCC) 和死亡风险的影响，并将其与代偿性肝硬化患者进行了比较。对 2008 年至 2022 年间连续接受 TIPS 的肝硬化患者进行了观察性研究。使用 Baveno VII 的再补偿定义，包括使用或不使用利尿剂/肝性脑病预防的患者。使用连续代偿期肝硬化患者的前瞻性队列进行比较。总体而言，纳入了 208 名肝硬化患者，其中 92 名代偿期患者和 116 名失代偿期患者接受了 TIPS。 1年后，24%的人获得了补偿。肝功能（MELD 12 ± 5 与 15 ± 6；p = .049）、LDL 胆固醇（97 mg/dL 与 76 mg/dL，p = .018）、白细胞计数（7.96 × 109/dL 与6.24 × 109/dL，p = .039）和血小板（129 × 109/dL vs. 101 × 109/dL，p = .039）与补偿相关。再补偿与 HCC 风险降低相关 (p = .020)。多变量分析显示，未补偿患者的这种风险显着较高 (p = .003)，但与补偿患者相比，再补偿患者没有观察到差异 (p = .816)。同样，失代偿患者的生存率较低 (p = .011)，而再代偿和代偿患者之间没有观察到差异 (p = .677)。TIPS 后的再代偿对 HCC 和死亡的发生率有明显影响，具有类似的影响。预后优于代偿期肝硬化患者。肝功能与再代偿相关，这表明对有指征的患者考虑早期 TIPS 的重要性。© 2024 作者。约翰·威利 (John Wiley) 出版的《肝脏国际》

It has been described that recompensation can improve prognosis in patients with cirrhosis. However, recompensation after transjugular intrahepatic portosystemic shunt (TIPS) has not been studied. We evaluated the impact of recompensation after TIPS on the risk of hepatocellular carcinoma (HCC) and death, and we compared it with compensated cirrhosis patients.An observational study of consecutive patients with cirrhosis undergoing TIPS between 2008 and 2022 was performed. Baveno VII definition of recompensation was used including patients with or without diuretics/Hepatic encephalopathy prophylaxis. A prospective cohort of consecutive compensated cirrhosis patients was used for comparison.Overall, 208 patients with cirrhosis were included, 92 compensated and 116 decompensated who underwent TIPS. After 1 year, 24% achieved recompensation. Liver function (MELD 12 ± 5 vs. 15 ± 6; p = .049), LDL-cholesterol (97 mg/dL vs. 76 mg/dL, p = .018), white cell count (7.96 × 109/dL vs. 6.24 × 109/dL, p = .039) and platelets (129 × 109/dL vs. 101 × 109/dL, p = .039) were associated with recompensation. Recompensation was associated with a reduction in the risk of HCC (p = .020). Multivariable analysis showed that this risk was significantly higher in non-recompensated patients (p = .003) but no differences were observed in recompensated compared with compensated patients (p = .816). Similarly, decompensated patients presented lower survival rates (p = .011), while no differences were observed between recompensated and compensated patients (p = .677).Recompensation after TIPS has a clear impact on the incidence of HCC and death, with a similar prognosis than patients with compensated cirrhosis. Liver function is associated with recompensation, suggesting the importance of considering early TIPS in patients with indication.© 2024 The Author(s). Liver International published by John Wiley & Sons Ltd.