Recompensation: For Whom, When, and Why?

The current definition of recompensation, established at the Baveno consensus several years ago, was largely based on expert opinion at a time when robust longitudinal data were limited. Since then, accumulating clinical evidence has begun to redefine the concept of recompensation, suggesting that a broader and more heterogeneous group of patients may experience meaningful and sustained improvement. However, major questions remain unresolved, including whether recompensation can be recognized in patients requiring low-dose diuretics, in those treated with a transjugular intrahepatic portosystemic shunt (TIPS), and whether it should be restricted to etiologies that can be cured or instead defined by sustained clinical and functional improvement. In addition, it remains unclear whether the concept of recompensation can be applied to pediatric populations, where data are particularly scarce. The session speakers explore these evolving definitions, review emerging evidence and openly discussing ongoing controversies, including whether current practice should continue to rely on the Baveno definition or move toward updated, data-driven frameworks, with the goal of clarifying how recompensation should be understood and applied in contemporary clinical practice.