Despite 2021 has continued to be defined by our response to the COVID-19 pandemic, Anna Bosch, General Manager of EF CLIF, invited everyone to celebrate the many achievements of our Foundation throughout the year at the opening session of an event hosted by Paolo Angeli, Chair of the EASL-CLIF Consortium Steering Committee. Angeli welcomed participants and reflected on the difficulties in times of COVID-19 in the past two years reviewing with enthusiasm the many activities conducted by the EASL-CLIF Consortium and how ongoing studies are changing the setting of the Foundation. This year, the spotlight was on the ACLARA, CHANCE and COBALT studies. Principal investigators of each of these projects were invited to present results to members of the consortium.

Fifty-five people from 29 centers in 14 European countries joined this meeting.

Vicente Arroyo, Director of EF CLIF, talked about the new setting of the Foundation and provided an overview of former studies promoted by EF CLIF and conducted by the EASL-CLIF Consortium. Arroyo discussed the status of the Foundation and introduced Albimmune SL, a new joint venture between academics and industry to investigate the mechanisms of action of albumin on the immune system. He acknowledged the participation of many collaborating centers across the world that have contributed to the success of ACLARA and the ongoing CHANCE study. He presented the establishment of a new interest group constituted by junior clinicians and researchers as a new task force within the Foundation that will contribute to the dissemination and exploitation of research results. At last, Arroyo presented recent findings on the pathophysiology of acute decompensation of cirrhosis providing a novel paradigm for chronic liver disease.

Richard Moreau, Principal investigator of the ACLARA study, presented the final results of one of the latest large prospective projects promoted by EF CLIF with the collaboration of 44 centers in Latin America. Moreau concluded that this study has allowed for a better understanding about the epidemiology and pathophysiology of acute-on-chronic liver failure (ACLF), and has revealed the importance of genetic ancestry on the severity and high mortality associated with this syndrome.

Rajiv Jalan, Scientific Director of EF CLIF, talked about the CHANCE study, a global study conducted with the support of ELITA and ILTS that aims to assess the benefits of liver transplantation in patients with cirrhosis and ACLF. Many patients with ACLF grades 2 and 3 do not qualify for receiving a liver transplant due to the development of medical complications that are associated with an increased risk for short-term mortality. The primary objective of the CHANCE study is to provide evidence of the improvement in the survival rate of ACLF patients after liver transplant. Jalan reported on project progress and presented some preliminary data. Jalan invited researchers to submit proposals to conduct ancillary studies that advance the field of hepatology and would benefit from access to the CHANCE patient cohort clinical data and biospecimens collected. One such a project is LEOPARD that has entered phase II of the Horizon Europe research and innovation program.

Finally, Gautam Mehta, consultant at Royal Free Hospital, clinical researcher at Roger Williams Institute of Hepatology and Associate Professor at University College London, UK, presented some results and major outcomes from the ongoing COBALT study. COBALT started within the first few weeks after the vaccine against SARS-Cov-2 was available with the aim to assess the impact of vaccination on patients with cirrhosis and post-liver transplantation. The primary objective of the study is to gain a better understanding of the immune response on these patients after receiving a first, second and third dose of the COVID-19 vaccine. Mehta discussed also about an ongoing study in a pediatric cohort of patients and introduced prospective ancillary studies.

The messages throughout the event were encouraging and confirmed that our role is to have a positive impact on the world through the significant contributions of the chronic liver disease community. We hope that our discoveries will lead to a better understanding of liver disease and translate into novel therapies leading to increased survival and better quality of life of current and future patients with cirrhosis and ACLF.