Shuji Terai, Hiroteru Kamimura, Yoichi Hiasa, Norio Akuta, T. Ishikawa, Yuichiro Eguchi, Hironao Okubo, Takumi Kawaguchi, Miwa Kawanaka, Tatsuo Kanda, Masaaki Korenaga, Ryotaro Sakamori, Masahito Shimizu, Yoshio Sumida, Ryosuke Tateishi, Atsushi Tanaka, Naoki Tanaka, Yasuo Tanaka, Yuki Tahata, Masato Nakai, Tadashi Namisaki, Takashi Nishimura, Atsushi Hiraoka, Takeshi Matsui, Nami Mori, Akio Moriya, Tetsuo Takehara
In April 2023, the Japan Society of Hepatology published its official guidelines on liver rehabilitation for chronic liver disease. In this article, we summarize the current evidence on the role of liver rehabilitation in slowing the progression of chronic liver disease, particularly metabolic dysfunction-associated steatotic liver disease (MASLD), liver cirrhosis, and hepatocellular carcinoma (HCC). Specifically, we outline the following: (1) the definition of liver rehabilitation and its target population; (2) exercise therapy in liver rehabilitation according to disease state; (3) considerations for patients with complications; (4) nutritional therapy in liver rehabilitation; and (5) potential economic benefits. Liver rehabilitation represents a novel therapeutic approach for patients with chronic liver disease, and this guidance aims to promote high-quality clinical research and strengthen the evidence base for its application.