October 05th 2021 The 1st CHANCE investigator meeting attended by over 150 global collaborators Two kick-off working sessions were held on 16th and 22nd September. During the meetings, the CHANCE Study was put into perspective by the Coordinators and the Investigators

The CHANCE study is a close collaboration between EFCLIF, ELITA and ILTS and aims to evaluate in its entirety the role of liver transplantation for patients with advanced Grades of acute on chronic liver failure (ACLF). It was exciting to see that 3-centres (Argentina: 2; UK:1) had got the study underway and 17-patients had already been recruited

The speakers explored a wide range of topics and discussed the huge progress that has been made despite the difficulties with the pandemic and shared experiences. The Webinars were attended by over 150 investigators, PIs and other collaborators from 21-countries worldwide. Prof Rajiv Jalan, the Scientific Coordinator of the Study and Scientific Director of the EF Clif introduced the meeting and talked about the latest recommendations for transplanting ACLF patients that were being introduced by Health Authorities in Spain and in UK. He suggested that this was a game-changer for these sick patients. Prof Thierry Gustot, the PI of the study, focused on the aims and characteristics of CHANCE, while Anna Bosch, the General Manager of the EF Clif described the current state of the study illustrating the rapid progress with Ethics approvals and contract negotiations in the investigating centres. Cristina Sánchez, the head of the Data Management Centre of the EF Clif devoted her speech to the different ways for the teams to be informed and updated about the supplied materials, how to process samples, the import/export procedures and stock controls. The most important part of the session was dedicated to sharing experiences, challenges, and refining protocols. Dr Sebastián Marciano (Italian Hospital in Buenos Aires, Argentina), Dr Rachel Westbrook (UCL-Royal Free, London, UK), Dr Giovanni Perriconi (Niguarda Hospital, Milan, Italy), Dr Vinay Sundaram (Cedars-Sinay, Los Angeles, USA) and Prof Mohamed Rela (Dr Rela Institute & Medical Centre, Chennai, India) described the challenges they had encountered and how they had found solutions. These issues were then discussed by the participants, who shared their own experiences. A recording of the webinars will remain available online for people that were unable to attend or want to review the discussions. These webinars are intended to be held bi-annually. If the pandemic allows the 1st face to face meeting of the CHANCE investigators will take place at ILC, London in April 2022 and the 2nd one at ILTS, Istanbul in May 2022.