At UEG Week Berlin, experts highlighted key advances in cirrhosis management:

• Sarcopenia: Affects ~40% of cirrhotic patients; assess regularly using the liver frailty index. Gut dysbiosis and myostatin upregulation drive muscle loss. Prevention focuses on nutrition, exercise, and possible testosterone therapy.

• Portal Vein Thrombosis: Common in advanced disease; anticoagulation (LMWH or DOACs) improves survival and recanalization without raising bleeding risk. Use DOACs cautiously in Child B/C. TIPS remains effective for refractory cases.

• Hepatorenal Syndrome: Now viewed as partly structural and inflammatory. Terlipressin plus albumin remains first-line therapy, but requires close hemodynamic monitoring. Early AKI detection and urinary biomarkers (e.g., NGAL) may guide therapy and reduce readmissions.