TWO RESEARCH ACTIVITIES

EASL CLIF CHAIR

Performs clinical studies to improve the diagnosis and treatment of patients with Chronic Liver Failure (CLIF).

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GRIFOLS CHAIR FOR TRANSLATIONAL
RESEARCH

Promotes translational research studies in Chronic Liver Failure (CLIF).

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NEWS&EVENTS

September 28, 2023 The 3rd A-TANGO General Assembly sets up the upcoming clinical trial for success Members of the A-TANGO Consortium met online to discuss progress and ways to overcome major challenges in a clinical trial that will test safety of a combinatorial drug therapy in patients with chronic liver disease.

BARCELONA—The 3rd A-TANGO General Assembly took place online on 26 September 2023. The objective of these annual meetings is to share progress made throughout the year among members of the Consortium and create a better understanding of potential risks and limitations of the project. These meetings offer an opportunity to receive feedback from members of the Scientific and Ethical Advisory Board, Data and Safety Monitoring Committee and Impact Board, and make adjustments to ongoing and future activities based on their expert advice.

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September 21, 2023 Celebrating 10 years of CANONIC: Challenging traditional practices We caught up with Dr. Laure Elkrief at EASL Congress 2023 to discuss how results from the CANONIC study have changed the field of hepatology and participating in this large-scale study has impacted her career.

Dr. Laure Elkrief is Hepatologist and Assistant Professor at Tours University Hospitals, France, were she is currently carriyng out research on portal hypertension both in cirrhosis and vascular liver disease.

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September 20, 2023 Scientific Advisory Board members meet in Barcelona to evaluate EF CLIF's research activities over FY 2022 The annual Scientific Advisory Board Meeting took place on 19 September 2023 at the EF CLIF Headquarters in Barcelona, Spain. Members of the Executive Scientific Committee together with the Coordinating Investigators of the three EU-funded projects MICROB-PREDICT, DECISION and A-TANGO presented an overview of the research outputs over the last year and discussed progress of ongoing projects.

BARCELONA—The Scientific Advisory Board (SAB) is made up of internationally recognized researchers and clinicians with broad expertise in liver disease research. Officially established in 2022, the SAB provides advise about the EF CLIF research programs and overall strategy.

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August 30, 2023 Don't miss the ELITA–EF CLIF Monothematic Conference on ACLF, Alcohol and Liver Transplant On the occasion of the 30th Anniversary of the European Liver and Intestine Transplant Association (ELITA), EF CLIF joins efforts with this section of the European Society for Organ Transplantation (ESOT), to bring together experts in acute-on-chronic liver failure (ACLF) and liver transplantation to discuss current practices and the future of the field in Europe.

The purpose of the Monothematic Conference is to provide up-to-date scientific evidence on the role of liver transplantation in patients with acute-on-chronic liver failure (ACLF) or in active drinkers who are in urgent need of a liver transplant. More specifically, the two morning sessions will be dedicated to the diagnosis of ACLF and to the crucial issue of access to liver transplantation for patients with severe ACLF across Europe. The afternoon sessions will focus on the current treatment of alcoholic hepatitis and the place of liver transplantation in active drinkers. For both topics there will be round table discussion based on clinical cases.

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August 29, 2023 Behind CHANCE: Staying on top of patient recruitment Patricia Momoyo Zitelli is a member of the team that recruited the 500th patient in the CHANCE study, and won a free registration to attend the EASL Congress 2023. At our 5th CHANCE Investigator Meeting, we took the opportunity to catch up with her to learn more about her role and her highlights of the congress.

After graduating from the school of nursing in 2013, Patricia started at Hospital das Clínicas da Universidade de São Paulo in Brazil as a registered nurse. Over the years, she has gained a wealth of knowledge and expertise, and has actively participated in the coordination of complex and large-scale clinical studies.

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July 12, 2023 Celebrating 10 years of CANONIC: Enabling better clinical management of patients with ACLF To celebrate the 10th aniversary of the publication of results from the CANONIC study that allowed for the definition of the syndrome we refer to as "acute-on-chronic liver failure" (ACLF), we took the opportunity to catch up with Dr. Minneke Coenraad at the EASL Congress 2023 to discuss her views on the past, present and future of hepatology.

Dr. Minneke Coenraad is Gastroenterologist and Hepatologist at Leiden University Medical Center, The Netherlands. Her research covers a wide breadth of areas including hepatocellular carcinomas, complications of cirrhosis and liver transplantation.

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June 23, 2023 CHANCE investigators meet on the occasion of the EASL Congress 2023 in Vienna, Austria The 5th CHANCE Investigator Meeting took place on 22 June 2023 in Vienna, Austria

VIENNA—On the occasion of the EASL Congress 2023, the 5th CHANCE Investigator Meeting brought together investigators, research nurses, data managers, statisticians and bioinformaticians to review and discuss project progress and address key issues regarding the completion of patient records.

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June 02, 2023 New hemodialysis machine proves safe and effective for treatment of acute-on-chronic liver failure The first-in-human clinical trial of DIALIVE, a liver dialysis device, meets safety requirements and shows improvement of pathophysiological markers of chronic liver disease reducing time to resolution of acute-on-chronic liver failure compared to standard of care.

BARCELONA—Acute-on-chronic liver failure (ACLF) is a syndrome associated with severe systemic inflammation, multiorgan system failure and high short-term mortality. Liver transplantation is the only one treatment option for patients with ACLF able to restore essential functions of the liver where no alternative treatment of comparable effectiveness exists. DIALIVE, a new liver dialysis device, demonstrated its potential as a disease-modifying therapy and improved markers underlying the physiopathology of ACLF. Results from the first-in-human clinical trial of DIALIVE were published ahead of print in

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May 30, 2023 Differences in percentage of Native American ancestry are associated with the odds to develop severe acute-on-chronic liver failure and risk of short-term mortality in the Latin American population A large prospective observational study carried out in Latin America finds high prevalence of severe acute-on-chronic liver failure and high risk of 28-day mortality in patients hospitalized for acute decompensation of cirrhosis with a higher percentage of Native American ancestry (and reported race) than that of European and African descent.

BARCELONA—The basis of genetic ancestry (and race) underlying differences in disease occurrence, outcomes or response to treatment remains unclear and most often racial and ethnic diversity is underrepresented in clinical research contributing to further expand the gap of health inequities. According to the Global Burden of Disease 2010 study, complications of cirrhosis accounted for 1 million deaths worldwide and caused 31 million disability adjusted life years (DALYs) that year. Noteworthy, liver cirrhosis mortality in Mexico was the highest in Latin America in 2010 with a mortality rate of 38.3 per 100,000. Patients with acute decompensation of cirrhosis suddenly develop ascites, hepatic encephalopathy, gastrointestinal hemorrhage, or any combination thereof. The CANONIC study, the first large, observational study carried out in Europe by the European Association for the Study of the Liver-Chronic Liver Failure (EASL-CLIF) Consortium, identified acute-on-chronic liver failure (ACLF) as a distinct syndrome that develops in 30% of patients with acute decompensation of cirrhosis, and is characterized by acute systemic inflammation, multi-system organ failure, and a high risk of death within 28 days after hospital admission. The ACLARA study – Prevalence, epidemiology, characterization and mechanism of ACLF in Latin America – sheds new light on the potential impact of genetic ancestry and reported race on the severity of ACLF and risk of short-term mortality. The study carried out in 1274 patients non-electively hospitalized for acute decompensation of cirrhosis in 44 university hospitals from 27 cities in 7 Latin American countries (Argentina, Brazil, Chile, Colombia, Mexico, Paraguay, and Peru), highlights the importance of including genetic ancestry (and race) in liver disease research and clinical practice for being variables that capture relevant epidemiological information. Findings from this study, published ahead of print in Gastroenterology, show that social factors (i.e., admission to public hospitals compared to private hospitals) and markers of organ function independently correlate with higher short-term mortality. The data also suggest an association between increased percentage of Native American ancestry (and reported race) and development of ACLF independent of alcohol-related hepatitis and bacterial infections, two major precipitant events of acute decompensation of cirrhosis and progression to ACLF.

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May 16, 2023 A CHANCE for researchers to win a registration for The Liver Meeting 2023 We call all investigators in CHANCE to help us reach the 1000th patient milestone

The CHANCE study aims to recruit 2000 patients by the end of 2023. With 58 actively recruiting centers in 20 countries across the world, we are confident that CHANCE will render positive results and provide answers to our primary objective: To compare 1-year graft and patient survival rates after liver transplantation in patients with acute-on-chronic liver failure (ACLF) grade 2 or 3 at the time of liver transplantation with patients with decompensated cirrhosis without ACLF and transplant-free survival of patients with ACLF grade 2 or 3 not listed for liver transplantation.

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May 05, 2023 CHANCE investigators meet on the occasion of ILTS 2023 in Rotterdam, The Netherlands Having reached a mid-point in the CHANCE study, the 4th CHANCE Investigator Meeting reunited investigators across participating centers to discuss about project progress on 4 May 2023 in Rotterdam, The Netherlands.

ROTTERDAM—The 4th CHANCE Investigator Meeting took place in Rotterdam, The Netherlands on the occasion of the 2023 International Congress of ILTS, ELITA and LICAGE (ILTS 2023). The CHANCE investigator meeting brought together 35 investigators and professionals from 12 countries (Argentina, Austria, Canada, France, Germany, India, Italy, Japan, Spain, The Netherlands, UK, and USA), 22 people attended in person and 13 joined online, to review and discuss project progress and address challenges of patient recruitment and data collection.

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February 23, 2023 Celebrating 10 years of CANONIC: It's all about improving care and survival for patients with ACLF To celebrate 10 years since the publication of results from the CANONIC study, we talked with Prof. Richard Moreau, leading researcher in this prospective observational investigation, about the impact of chronic liver disease, approaches to treatment, and best practices.

The CANONIC study – European Association for the Study of the Liver (EASL)–Chronic Liver Failure (CLIF) Consortium acute-on-chronic liver failure in cirrhosis – was unprecedented in its scope and findings providing the means for the first evidence-based definition of the syndrome referred to as "acute-on-chronic liver failure" (ACLF). Although no universal definition of ACLF has been yet recognized, the EASL-CLIF Consortium diagnostic criteria has been applied and validated worldwide. Results from the CANONIC study opened up a new venue of liver disease research that will continue expanding in the following years.

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February 17, 2023 International Day of Women and Girls in Science: Debbie Shawcross Meet Debbie Shawcross, MD, PhD, Professor of Hepatology and Chronic Liver Failure at King's College London and King's College Hospital NHS Foundation Trust, UK, and member of our Inspiring and Writing Group.

In celebration of International Day of Women and Girls in Science, we want to raise awareness of the work of women in hepatology and inspire the next generation of budding scientists.

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February 16, 2023 International Day of Women and Girls in Science: Dominique Thabut Meet Dominique Thabut, MD, PhD, Professor in Hepatology, Intensive Care Unit at the Pitié-Salpêtière Hospital AP-HP, Sorbonne Université, France, and member of our Inspiring and Writing Group.

In celebration of International Day of Women and Girls in Science, we want to raise awareness of the work of women in hepatology and inspire the next generation of budding scientists.

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February 16, 2023 International Day of Women and Girls in Science: Vanessa Stadlbauer-Köllner Meet Vanessa Stadlbauer-Köllner, MD, Associate Professor at the Medical University of Graz, Internal Medicine and Hepatology-Gastroenterology consultant at the University Hospital Graz, Austria, and member of our Inspiring and Writing Group.

In celebration of International Day of Women and Girls in Science, we want to raise awareness of the work of women in hepatology and inspire the next generation of budding scientists.

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February 14, 2023 International Day of Women and Girls in Science: Meritxell Ventura-Cots Meet Meritxell Ventura-Cots, MD, PhD, staff member and clinical researcher at Hospital Universitari Vall d'Hebron, Spain, and member of our Inspiring and Writing Group.

In celebration of International Day of Women and Girls in Science, we want to raise awareness of the work of women in hepatology and inspire the next generation of budding scientists.

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February 11, 2023 International Day of Women and Girls in Science: Sara Montagnese Meet Sara Montagnese, MD, PhD, Associate Professor of Internal Medicine at University of Padova, Italy, Professor of Chronobiology at University of Surrey, UK, and member of our Inspiring and Writing Group.

In celebration of International Day of Women and Girls in Science, we want to raise awareness of the work of women in hepatology and inspire the next generation of budding scientists.

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February 10, 2023 International Day of Women and Girls in Science: Rosa Martín-Mateos Meet Rosa Martín-Mateos, MD, PhD, Consultant at Hospital Universitario Ramón y Cajal and Researcher at Universidad de Alcalá - Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), CIBERehc, Instituto de Salud Carlos III, Spain, and member of our Inspiring and Writing Group.

In celebration of International Day of Women and Girls in Science, we want to raise awareness of the work of women in hepatology and inspire the next generation of budding scientists.

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February 08, 2023 International Day of Women and Girls in Science: Ingrid Zhang Meet Ingrid Zhang, MD, PhD, Research Fellow of the Clinician Scientist Program supported by the Berlin Institute of Health in the Department of Hepatology and Gastroenterology at Charité – Universitätsmedizin Berlin, Germany, and member of the EF CLIF Inspiring and Writing Group.

In celebration of International Day of Women and Girls in Science, Ingrid gives insights into her work and shares her hopes and research goals as a scientist.

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February 07, 2023 International Day of Women and Girls in Science: Virginia Hernández-Gea Meet Virginia Hernández-Gea, MD, PhD, Senior Specialist in Hepatology at Hospital Clínic de Barcelona-IDIBAPS, Spain, and member of our recently established Inspiring and Writing Group.

In celebration of International Day of Women and Girls in Science, we want to raise awareness of the work of women in hepatology and inspire the next generation of budding scientists.

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January 23, 2023 The 5th MICROB-PREDICT General Assembly brings together members of the consortium to review next steps in the ALB trial startup process The MICROB-PREDICT General Assembly is an annual flagship event within the MICROB-PREDICT Consortium that brings together active members, work package leaders, and representatives of the different advisory committees and boards to assess project progress and exchange knowledge and ideas.

BARCELONA—The 5th MICROB-PREDICT General Assembly meeting took place in Budapest, Hungary, from 17 to 19 January 2023. Partners from 16 institutions in 10 countries met to review progress within MICROB-PREDICT and set the ALB trial up for success.

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January 11, 2023 Meet our new trustee, Ignasi Bruguer We recently welcomed Ignasi Bruguer to our Board of Trustees.

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