Fig. 1

Clinical stages of cirrhosis. The first major classification is based on the absence or presence of complications. Cirrhosis is named ‘compensated’ in the absence of complications, and ‘decompensated’ if complications are present or have been present in the past. In patients with compensated cirrhosis, the presence of clinically significant portal hypertension (HVPG ≥ 10 mmHg) identifies a substage with higher risk of developing any complication (varices, decompensation). The decompensated stage is characterized by a high risk of progression to further decompensation, liver failure, and death. Evidence-based therapy has been developed by targeting the pathophysiological mechanisms driving the transition from a given step to the following one. The major advances in each stage are indicated within the figure