Although liver transplantation has been shown to be the most effective treatment for patients with ACLF grade 2-3 to date, with more than an 80% survival rate after 1 year of receiving a liver transplant (Belli et al., 2021), access to liver transplantation in some European countries is limited in treating patients with cirrhosis. In collaboration with the European Liver and Intestine Transplantation Society (ELITA) and the International Liver Transplantation Society (ILTS), EF CLIF launched the CHANCE study, its largest prospective non-interventional observational global study in order to assess the survival rate of patients with cirrhosis who receive a liver transplant.

CHANCE – Liver transplantation in patients with cirrhosis and severe acute-on-chronic liver failure: Indications and outcomes – is a three-year study that will recruit 2000 patients from 93 hospitals in 29 countries around the globe, bringing together renowned surgeons, hepatologists, pathophysiologists, and researchers who are collaborating to collect and analyze patients’ clinical data and samples. CHANCE success very much relies on patient participation. More than 100 patients are now enrolled in the study.“Despite the global pandemic of COVID-19 and the regulatory challenges of a global study, the CHANCE study team and multiple outstanding investigators have accomplished a feat. We have just surpassed 100 patients enrolled. With new centers and active countries coming on board, we plan to accelerate enrollment to meet our goals”, said Thierry Gustot, Principal Investigator of the CHANCE study and Director of the Liver Transplant Unit at Erasmus Hospital and Senior Lecturer at Université libre de Bruxelles, Belgium.

The CHANCE study will contribute to the drafting of new protocols and standards for establishing the selection criteria for transplantation in patients with ACLF. The overarching aims of this study are to define better criteria for patient selection and make transplantation available to patients developing ACLF, a step forward towards harmonization across the world. “The results of this study are eagerly awaited in an attempt to resolve the inadequacies of the organ allocation rules for severe ACLF patients. With the multiple samples collected, we hope to explore the mechanisms responsible for the resolution of ACLF to open new therapeutic avenues”, explained Gustot.

Further reading

Belli, L.S.; Duvoux, D.; Artzner, T.; Arroyo, V.; Jalan, R.; for the ELITA/EF-CLIF working group. Liver transplantation for patients with acute-on-chronic liver failure (ACLF) in Europe: Results of the ELITA/EF-CLIF collaborative study (ECLIS). J. Hepatol. 2021, 75 (3), 610–620. DOI: 10.1016/j.jhep.2021.03.030