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 the first large, prospective study ever conducted aimed at establishing a definition for acute-on-chronic liver failure (ACLF). Prof. Arroyo is internationally renowned for his research liver disease and inflammation.
READ MOREAntimicrobial resistance (AMR) occurs when bacteria, viruses, fungi and parasites no longer respond to antimicrobial agents. As a result of drug resistance, antibiotics and other antimicrobial agents become ineffective and infections become harder or impossible to treat, increasing the risk of disease spread, severe illness and death.
READ MOREAt our 6th CHANCE Investigator Meeting in Boston, MA, USA, we caught up with Prof. Farias who shared his view on the findings of the study and their wider implications. As part of our campaign to recruit patient no. 1000, Prof. Farias received free registration to attend the American Association for the Study of Liver Diseases (AASLD) annual meeting, The Liver Meeting® (TLM 2023). We took this opportunity to ask him about his insights from the conference and emerging topics in the field of hepatology.
READ MOREThe 6th CHANCE Investigator Meeting took place on 10 November 2023 in Boston, MA, USA, on the occasion of The Liver Meeting 2023 – the annual meeting of the American Association for the Study of Liver Diseases (AASLD).
READ MOREBARCELONA—Inadequate supply and lower acceptance rate of COVID-19 vaccines among the adult population remains a matter of concern, particularly in high-risk groups such as patients with chronic liver disease and liver transplant recipients. In people receiving a liver transplant, reduced antibody response to COVID-19 vaccination is known to be associated with the use of immunosupressants and older age. The variable response to COVID-19 vaccines in people with cirrhosis has largely prevented the identification of factors associated with risk and severity of breakthrough infection in this group. The COBALT study – COVID-19 vaccination and biomarkers in cirrhosis and post-liver transplantation – coordinated and sponsored by the European Foundation for the Study of Chronic Liver Failure (EF CLIF) with the support of the Foundation for Liver Research, the European Liver and Intestine Transplant Association (ELITA), the European Liver Patients' Association (ELPA), and the European Association for the Study of the Liver (EASL) aimed to determine the degree of protection conferred by COVID-19 vaccines in people with chronic liver disease and post-liver transplantation. The study published in Hepatology Communications provides evidence of the heterogenous response of COVID-19 vaccine primary series and identifies factors predicting poor vaccine response and risk of breakthrough infection in people with cirrhosis, patients with autoimmune liver disease without cirrhosis, and who have undergone liver transplantation compared to healthy individuals with no previous COVID-19 infection episode and no infection with human immunodeficiency virus.
READ MOREPADOVA—The DECISION General Assembly was held on 18–20 October 2023 and run in a hybrid format from Padova, Italy. This annual meeting is meant to bring together members of partner institutions to review project progress and help researchers to put their results into perspective, sharing their findings contributes to add clarity to the studies carried out within the project and set the direction to achieve expected project outcomes.
READ MOREBARCELONA— The Ranking of the World Scientists: World's Top 2% was created by a group of experts led by John P.A. Ioannidis (Stanford University), Jeroen Baas (Elsevier B.V.) and Kevin W. Boyack (SciTech Strategies). The database is publicly available in the Elsevier Data Repository and regularly updated providing information on career-long and single most recent year impact.
READ MOREBARCELONA—The CHANCE Management Team announces the recruitment of patient no. 1000. This new milestone means that the study will progress to a data cleaning stage and primary endpoints will be analyzed. The CHANCE study aims to describe the clinical trajectories of patients with acute decompensation of cirrhosis and ACLF in the liver transplant waiting list, and is expected to contribute to issue new guidelines for organ allocation as there are currently no specific priority criteria for patients with ACLF.
READ MOREHere, newly elected center coordinators Beti Todorovska, MD, PhD for University Clinic of Gastroenterohepatology (Macedonia), Genco Gençdal, MD for Koç University Hospital (Turkey) and Maria Pilar Ballester, MD, PhD for Hospital Clínico Universitario de Valencia (Spain), tell us about their motivations for joining the EASL-CLIF Consortium.
READ MOREBARCELONA—The CHANCE Steering Committee Meeting was held online on 3 October 2023 to review the in-depth patient follow-up assessment carried out by EF CLIF Data Managers and Statisticians over the last few months and to foster discussion around the available data against the primary and secondary endpoints of the study.
READ MOREBARCELONA—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.
READ MOREDr. 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.
READ MOREBARCELONA—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.
READ MOREThe 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.
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.
READ MOREDr. 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.
READ MOREVIENNA—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.
READ MOREBARCELONA—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
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.
READ MOREThe 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.
READ MOREROTTERDAM—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.
READ MOREThe 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.
READ MOREBARCELONA—Systemic inflammation is the major driver of acute decompensation of cirrhosis contributing to the development and severity of acute-on-chronic liver failure (ACLF) – a syndrome associated with multiorgan failure and high short-term mortality. About 20% of patients with acute decompensation of cirrhosis develop ACLF within three months of hospitalization. The model for end-stage liver disease (MELD) has been widely used to predict mortality in patients with acute decompensation of cirrhosis and to prioritize patients for liver transplantation. However, MELD and its variations fail to predict early deaths in ACLF patients. The Chronic Liver Failure Consortium acute-on-chronic liver failure (CLIF-C ACLF) score has proven to be superior, yet has limitations in predicting short-term mortality in a significant number of patients. In a previous study, researchers at EF CLIF showed that the presence of a set of metabolites – small molecules that function as intermediate or end products of metabolic reactions that occur throughout the body – correlated with severity of systemic inflammation and ACLF.
READ MOREIn 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.
READ MOREIn 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.
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.
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.
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.
READ MOREIn 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.
READ MOREIn 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.
READ MOREIn 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.
READ MOREBARCELONA—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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