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

November 30, 2022 Perceptions and practices impact equity in access to liver transplantation for critically ill patients with cirrhosis A survey on the attitudes towards liver transplantation for patients with acute-on-chronic liver failure grade 3 (ACLF-3) reveals differences between countries and transplant centers.

BARCELONA—While liver transplantation is the most effective treatment available for patients with ACLF-3, access to liver transplantation for these critically ill patients with underlying cirrhosis and multiorgan failures varies greatly across countries and transplant centers in each country. Barriers to access to liver transplantation may include admission to the intensive care unit, referral to a tertiary hospital, timely organ allocation, and listing for liver transplant. Access to liver transplantation for patients with ACLF-3, although, requires agreement between all members of the transplant team, but also health professionals at primary and secondary centers should be aware of liver transplantation as potential treatment for patients with cirrhosis that require critical care.

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November 28, 2022 Hospital das Clínicas da Universidade de São Paulo in Brazil recruits patient no. 500 in the CHANCE study Following our campaign to accelerate recruitment in the CHANCE study, we spoke with Prof. Dr. Alberto Farias who leads the team at Hospital das Clínicas da Universidade de São Paulo that recruited the 500th patient.

BARCELONA—On 17 November 2022, our collaborators at Hospital das Clínicas da Universidade de São Paulo in Brazil recruited patient no. 500. Provided sufficient data, this will allow us to conduct an interim assessment and guide future directions in the study.

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November 23, 2022 First face-to-face meeting of the Inspiring & Writing Group After the establishment of the Inspiring and Writing Group early in 2022, members of this working group met for the first time in person at the EF CLIF Headquarters in Barcelona, Spain, to present ancillary studies from CANONIC, PREDICT, and ACLARA.

BARCELONA—The Inspiring and Writing Group works across disciplines and brings together expertise in end-stage liver disease, liver transplantation, critical care, gut microbiome, hepatic vascular disorders, hepatic encephalopathy, acute kidney injury, and liver regeneration. On the first face-to-face meeting of the Inspiring and Writing Group, members which project proposal was successful in an internal call, presented the rationale behind their project and expected outcomes.

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November 18, 2022 World Antimicrobial Awareness Week 2022 - Preventing antimicrobial resistance together 18–24 November is World Antimicrobial Awareness Week (WAAW) and we are celebrating by highlighting the work of EF CLIF researchers who contribute efforts to tackle antimicrobial resistance in patients with liver disease

BARCELONA—Multidrug-resistant bacterial infections constitute an increasing healthcare problem that negatively impacts survival of patients with liver disease. Strategies to prevent the spread of antimicrobial resistance in liver disease, particularly decompensated cirrhosis and acute-on-chronic liver failure (ACLF), should be urgently addressed.

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November 07, 2022 CHANCE investigators meet on the occasion of The Liver Meeting 2022 in Washington D.C, USA The 3rd CHANCE Investigator Meeting took place on 4 November 2022 in Washington D.C, USA

BARCELONA—The 3rd CHANCE Investigator Meeting took place in Washington D.C., USA, on the occasion of the 73rd Annual Meeting of the American Association for the Study of Liver Diseases (ASSLD). The CHANCE investigator meeting brought together 46 investigators and professionals from 10 countries (Argentina, Canada, France, Germany, India, Italy, Spain, The Netherlands, UK, and USA), 34 people attended in person and 12 joined online, to review and discuss project progress, share experiences and address challenges of patient recruitment.

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October 31, 2022 ELITA 30th Anniversary Meeting & ELITA-EF CLIF Monothematic Conference about ACLF, Alcohol and Liver Transplant On the occasion of the 30th Anniversary of the European Liver and Intestine Transplant Association (ELITA), we join 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.

Target group: Liver and transplant surgeons, hepatologists, intensive care specialist, transplant anaesthesiologists, transplant fellows.

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October 24, 2022 The 4th DECISION General Assembly brings together members of the consortium to review project progress and design the COMBAT trial protocol As the DECISION project reaches a critical point, members of the consortium meet in Madrid, Spain, to discuss progress and results from multiomics analyses performed in a large cohort of patients with acute decompensation of cirrhosis and acute-on-chronic liver failure to decide what are the next actions towards testing the best combinatorial therapy possible for these patients

BARCELONA—The 4th DECISION General Assembly meeting took place in Madrid, Spain, from 19 to 21 October 2022. This meeting brought together partners from 21 institutions and industry in 10 countries to review progres and discuss further about most recent results leading to biomarker candidates that can better predict prognosis of acute decompensation of cirrhosis. With the aim to develop novel therapeutic approaches to treat cirrhotic patients that develop acute-on-chronic liver failure (ACLF), the COMBAT trial within DECISION will evaluate safety of most promissing drug combinations identified through data-driven approaches and validated in pre-clinical studies using animal models of liver disease.

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October 17, 2022 The patient perspective Today, it is widely recognized the role of patients in clinical research beyond their participation as research subjects. Patients' organizations continue evolving in their role of supporting patients and their families, advocating and publicly representing the collective identity of their members to raise awareness of their disease and influence health policymakers. More recently, the role of expert patient has emerged to input their unique experiences into research.

At the European Foundation for the Study of Chronic Liver Failure (EF CLIF), we belief that incorporating the patients' perspective in clinical research is critical to ensure that the research outcomes we measure reflect those which are most relevant to patients. Within the European Union-funded projects we coordinate, namely, MICROB-PREDICT, DECISION and A-TANGO, the European Liver Patients' Association (ELPA) is involved as a partner with representation in several stakeholder groups and committees of all three consortia.

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October 14, 2022 A CHANCE for researchers to win a registration for the EASL Congress 2023 We are close to reaching 500 patients and we would like to celebrate this milestone with all our colleagues and collaborators in the CHANCE study

Our target of recruiting 2,000 patients is still far behind, but with more active centers joining every month and the collective effort of all the centers that are already open across the world, we are certain that we will reach our goal soon.

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October 07, 2022 Our statement on the passing of Ignacio Calero, member of our Board of Trustees On behalf of our staff, members of our Board of Trustees, and all our colleagues and collaborators, we offer our condolences to Ignacio Calero's family at this time of sadness

Ignacio Calero was a member of our Board of Trustees since the establishment of the European Foundation for the Study of Chronic Liver Failure (EF CLIF) in 2015.

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October 04, 2022 The 3rd CHANCE Investigator Meeting will take place in Washington, D.C., USA The 3rd CHANCE Investigator Meeting will be held on 4 November 2022 in Washington, D.C., USA on the occasion of the 73rd Annual Meeting of the American Association for the Study of Liver Diseases (AASLD 2022)

Newly appointed Regional Coordinators for North America, Constantine Karvellas (University of Alberta, Canada) and Ruben Hernaez (Michael E. DeBakey Veterans Affairs Medical Center, TX, USA), will be officially introduced to all CHANCE Investigators at this event.

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October 01, 2022 European Day of Donors and Foundations — Solidarity, Unity, Impact On 1 October, we wanted to reflect on the theme for the European Day of Donors and Foundations 2022 – Solidarity, Unity, Impact

The European Day of Donors and Foundations is an initiative to celebrate the role of philanthropy at the European level and raise public awareness about the value of civic action.

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September 30, 2022 Looking ahead after ACLARA Connecting and strengthening relationships with the Latin American hepatology community is one of our strategic priorities. The ACLARA study set the framework to conduct large-scale investigations in Latin America and opened the possibility to establish future collaboration with tertiary care centers and university hospitals across the region

We were pleased to welcome Principal Investigator of the ACLARA study, Prof. Flair José Carrilho, this month at the EF CLIF Headquarters in Barcelona. During his visit, he met with Prof. Vicente Arroyo, Director of EF CLIF, and Prof. Richard Moreau, Emeritus Researcher at the French Institute of Health and Medical Research (INSERM), Consultant in Hepatology at Hôpital Beaujon, France, and Honorary Director of the Grifols Chair at EF CLIF, who acted as Principal Investigator for Europe for the ACLARA study. They hold long meetings with our data managers, biostatisticians and bioinformaticians to discuss further about the results of the ACLARA study and polish a manuscript that will be submitted shortly for publication.

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September 30, 2022 New collaborative research describes the lack of consensus among European transplant centers in the clinical management of patients with ACLF-3 The results from this retrospective study highlight the inequity of access to intensive care unit, waitlisting, and liver transplantation for patients with acute-on-chronic liver failure grade 3 (ACLF-3) in 20 centers from 8 European countries

BARCELONA—Liver transplantation appears to be the most effective treatment for patients with ACLF-3. Yet, in practice, liver transplant is not widely used in Europe for treatment of these patients for being considered to be too sick.

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September 14, 2022 A new EASL position paper reviews currently known liver-specific effects of COVID-19 and provides guidance on the care of adult liver patients Researchers at the European Foundation for the Study of Chronic Liver Failure contribute to an updated position paper by the European Association for the Study of the Liver (EASL) on the impact of COVID-19 in patients with chronic liver disease, hepatobiliary cancer, and liver transplantation

BARCELONA—The emergence of new variants of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) over the last two years has represented a serious challenge for healthcare professionals and liver patients worldwide. The B.1.1.529 (omicron) SARS-CoV-2 variant, being more transmissible and resistant to neutralization, rapidly displaced the B.1.617.2 (delta) variant. Besides omicron infection appears to be associated to milder symptoms, preliminary data on omicron natural immunity were still inconsistent by the time EASL position statements were published. The updated EASL position paper, although, provides a comprehensive review of liver-specific effects of COVID-19 infected patients with chronic liver disease, hepatobiliary cancer, and after liver transplantation.

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September 12, 2022 Reframing our brand It may be just a subtle change what you may have noticed, but for us at the European Foundation for the Study of Chronic Liver Failure represents a great improvement. Some fresh changes may be noticeable: the update of our logo which now displays new fonts and expansion of our color palette for a range of applications.

We took this opportunity to enhance our brand position and reflect on our fundamental aspiration to become a global reference in the field of chronic liver disease. Our brand proposition now incorporates elements that will contribute to make a positive impact on the liver community and beyond.

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June 26, 2022 New center in Europe elected member of the EASL-CLIF Consortium The new member of the EASL-CLIF Consortium joins a network of more than 100 university hospitals and tertiary medical centers in Europe

LONDON—Since its foundation in 2009, the EASL-CLIF Consortium has been devoted to the advancement of knowledge on the pathophysiology, diagnostics, and treatment of cirrhosis.

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June 25, 2022 The 2nd CHANCE Investigator Meeting brings together investigators around the globe to share their insights on project progress The 2nd CHANCE Investigator Meeting took place on 24 June 2022 in London, UK

LONDON—The 2nd CHANCE Investigator Meeting took place in London, UK, during the celebration of the International Liver Congress 2022 organized by the European Association for the Study of the Liver (EASL). This event brought together 49 investigators and professionals from 18 countries (Argentina, Belgium, Brazil, Czech Republic, France, Germany, India, Italy, Japan, Poland, South Korea, Spain, Switzerland, Taiwan, The Netherlands, Turkey, UK and USA), 27 people attended in person and 22 joined online.

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June 24, 2022 The EASL-CLIF Consortium Steering Committee meets to review and discuss progress of research activities in the previous year The annual meeting of the EASL-CLIF Consortium Steering Committee took place on 23 June 2022 in London, UK

LONDON—Within the European Foundation for the Study of Chronic Liver Failure (EF Clif), the EAS-CLIF Consortium Steering Committee oversees the research activities of the EASL-CLIF Consortium, a network of more than 100 tertiary care and university hospitals in 28 European countries.

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June 23, 2022 The General Assembly of the EASL-CLIF Consortium reunites its members in an extraordinary online meeting The annual General Assembly of the EASL-CLIF Consortium took place in an online format on 21 June 2022 in London, UK

LONDON—Within the framework of the EASL Chair activities, every year members of the EASL-CLIF Consortium reunite to discuss progress of current clinical studies and set out the impacts of the achievements during the former year. This meeting was originally planned as an in-person event at ExCeL London at the start of the International Liver Congress 2022 organized by the European Association for the Study of the Liver (EASL), but finally took place online due to the 2022 UK railway strike. In order to facilitate participation, the EF Clif management support team made the necessary arrangements to ensure a successful meeting.

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June 01, 2022 COVID-19 vaccination protects patients with liver disease or receiving liver transplant from infection Collaborative research finds low risk of SARS-CoV-2 infection and mild symptoms in infected patients with cirrhosis, autoimmune liver disease or after liver transplantation following two doses of the COVID-19 vaccine.

BARCELONA—Cirrhosis and chronic liver disease are associated with dysregulation of the immune system. Previous studies have demonstrated that patients with cirrhosis are at increased risk of death from COVID-19, but few data exist on immunity following vaccination in cirrhosis and post-liver transplant patients. Recent findings from researchers at the European Foundation for the Study of Chronic Liver Failure (EF CLIF) and collaborators in Spain, Italy, the Netherlands and UK provide evidence of the effectiveness of the vaccine in patients with cirrhosis, autoimmune liver disease or post-liver transplantation.

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May 27, 2022 The EASL-CLIF General Assembly Meeting will take place in London, UK in June 2022 Members of the EASL-CLIF Consortium are invited to attend the General Assembly Meeting that will be held online from London, UK.

Do not miss this opportunity to meet and discuss progress on the EASL-CLIF Consortium activities in this meeting chaired by Paolo Angeli, Chair of the EASL-CLIF Consortium Steering Committee, and Rajiv Jalan, Scientific Director of the European Foundation for the Study of Chronic Liver Failure (EF Clif).

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May 16, 2022 Liver transplantation for patients with ACLF: The knowns and unknowns EF Clif Scientific Director, Rajiv Jalan, presented progress of the CHANCE study at ILTS 2022

A special session at the ILTS 2022 focused on acute-on-chronic liver failure prognosis and put liver transplantation and organ allocation policy into perspective. An event hosted by ILTS President Marina Berenger (Hospital Universitario La Fe, Spain) and Program Chair, ILTS President-elect Mohamed Rela (Dr. Rela Institute and Medical Center, India), where Rajiv Jalan presented the design and progress of the CHANCE study.

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May 16, 2022 The 2nd A-TANGO General Assembly was held on 11–13 May 2022 in Castelldefels, Spain More than one year after the kick-off meeting meeting of the EU-funded A-TANGO project, participants at partner institutions met for three days in Castelldefels, Spain, to discuss progress and the challenges of conducting a clinical trial to test the effectiveness and safety of a novel combinatorial therapy for the treatment of acute-on-chronic liver failure (ACLF)

BARCELONA—The A-TANGO General Assembly meeting brought together early career researchers, industry experts and leading clinical researchers participating in this project to review progress and celebrate the achievements accomplished to date.

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May 02, 2022 The 2nd CHANCE Investigator Meeting 2022 The CHANCE Investigator Meeting will take place in London at the International Liver Congress 2022

Investigators of the CHANCE study are invited to attend to the CHANCE Investigator Meeting that will be held in-person and online on 24 June 2022 12:00–13:30. In celebration of the International Liver Congress 2022 in London, UK, organized by the European Association for the Study of the Liver (EASL), this extraordinary meeting will take place at ExCeL London, South Gallery 27.
Preliminary data will be presented and regional coordinators will share their insights. The EF Clif General Manager will also explain how to submit any proposals for ancillary studies that may derive from the CHANCE study.

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March 25, 2022 The 5th DECISION Steering Committee meeting was held on 23–24 March 2022 in Paris, France The 5th DECISION Steering Committee meeting reunited our partners to review project progress

BARCELONA—The 5th DECISION Steering Committee meeting was a two-day event where work package leaders presented preliminary results after one year and half of dedicated work and extensive analysis.

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March 21, 2022 The 4th MICROB-PREDICT General Assembly was held on 15–18 March 2022 in Mallorca, Spain A four-day event reunited 64 participants of the EU-funded project MICROB-PREDICT to discuss project progress before the start of the ALB-TRIAL

BARCELONA—Members of the MICROB-PREDICT consortium met in Mallorca, Spain, to present and discuss most recent results establishing the foundations for the upcoming ALB-TRIAL, a clinical trial to be conducted in 8 European centers that will validate biomarkers for decompensated cirrhosis and acute-on-chronic liver failure (ACLF) in response to albumin treatment.

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March 04, 2022 The impact of advanced cirrhosis on the time course of antibiotic distribution across and elimination from the body, in silico study suggests New study by researchers at EF Clif and Hospital Clínic de Barcelona uncovers alterations of antibiotic pharmacokinetics in patients with decompensated cirrhosis and severe bacterial infections

BARCELONA—Bacterial infections can cause severe complications in the clinical course of cirrhosis and ensuring adequate antimicrobial treatment is crucial to prevent associated complications and improve survival of patients with advanced liver disease. As cirrhosis progresses, liver function gradually deteriorates. Liver dysfunction results in hypoalbuminemia and in changes in bile acid synthesis in hepatocytes which in turn may alter the pharmacokinetic properties of certain drugs. Published on 18 February 2022 in Journal of Antimicrobial Chemotherapy, this study provides evidence of variations in the distribution and excretion of tigecycline, a broad-spectrum antibiotic frequently used for the treatment of severe bacterial infections in critically ill patients with and without cirrhosis.

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February 28, 2022 How alteration in the composition of albumin-associated lipids in acute decompensation of cirrhosis impairs resolution of inflammation New research investigates the changes in fatty acids bound to plasma albumin and its implications in the production of inflammatory and immunosuppressive lipid mediators in advanced liver disease

BARCELONA—Albumin administration has been proven to be an effective therapy for patients with acute decompensation of cirrhosis. Albumin, the most abundant protein in the bloodstream, is synthesized by the liver and its high affinity for fatty acids allows for the transport of lipids that serve as substrates for the synthesis of membrane phospholipids and some bioactive compounds. In advanced liver disease, post-translational modifications of albumin may result in changes in its lipid content and thus alter the circulating lipid profile.

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February 23, 2022 CHANCE recruits over 100 patients In July 2021, Ef Clif’s largest observational prospective study was launched with the aim to compare the survival rates of patients with acute-on-chronic liver failure after liver transplantation and transplant-free survival. The CHANCE study has now recruited more than 100 patients.

BARCELONA—Acute-on-chronic liver failure (ACLF) is a syndrome that develops in 30% of the patients hospitalized due to cirrhosis. About 30% of patients with ACLF will die within 28 days of hospital admission. Pioneering studies by the European Foundation for the study of Chronic Liver Failure (EF Clif) have been of paramount importance in defining new criteria for the diagnosis and prognosis of ACLF and addressing the underlying mechanisms that contribute to acute hepatic decompensation, multiorgan failure, and high risk of short-term mortality.

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February 03, 2022 First meeting of the Inspiring & Writing Group Twenty-seven participants, including internationally renowned leading researchers and EF Clif staff, discussed ways of advancing knowledge and education on acute-on-chronic liver failure in the 1st meeting of the Inspiring & Writing Group

Acute-on-chronic liver failure (ACLF) was recently described as a syndrome that leads to acute hepatic decompensation, multiorgan failure and a high risk of short-term mortality. Most common precipitating factors in ACLF, include bacterial infections, alcoholism and persistence and reactivation of viral hepatitis, although for some patients neither of these are observed. Current treatment strategies include organ support, liver transplantation and immunomodulating therapy, yet the mechanisms underlying ACLF remain unclear and the needs for critically ill patients with cirrhosis unmet.

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February 02, 2022 Rectal colonization by multidrug-resistant bacteria increases the short-term risk of infection in patients with cirrhosis requiring critical care Collaborative research between EF Clif, Hospital Clínic de Barcelona and Goethe University Frankfurt shows higher risk of infections by the rectal colonizing resistant bacteria in critically ill cirrhotic patients

BARCELONA—Currently, antibiotic resistance represents a major concern for patients with cirrhosis. Previous work suggested that colonization by multidrug-resistant bacteria increases the risk of resistant infections in non-cirrhotic patients. New research in two geographically distinct cohorts in Europe by a team at the European Foundation for the Study of Chronic Liver Failure (EF Clif), Hospital Clinic de Barcelona and Goethe University Frankfurt shows that rectal colonization by antibiotic-resistant bacteria is a frequent and clinically relevant problem in patients with cirrhosis requiring critical care. The type of colonizing bacteria was found to be heterogeneous between centers. This study provides evidence that rectal colonization by antibiotic-resistant bacteria is associated with high risk of infections by the colonizing strain in cirrhotic patients admitted to the intensive care unit. Therefore, early detection of resistant carriers opens up the possibility for targeted antibiotic therapies and rapid isolation strategies. These measures in combination may contribute to reduce the spread of antibiotic resistance among hospitalized patients with cirrhosis. This work was published on 22 January 2022 in Journal of Hepatology.

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November 11, 2021 Nationwide population-based study of 250 million hospital admissions in Germany reveals changing trends in the course of cirrhosis and its complications From 2005 to 2018, hospital admissions due to cirrhosis have increased in Germany. Patients admitted in hospital with a diagnosis of cirrhosis were younger compared to other chronic diseases, mainly male, and showed the highest mortality rate during their stay in hospital

BARCELONA—End-stage chronic liver disease, also named decompensated cirrhosis, is a major cause of morbidity and mortality and represents a global burden. The epidemiology of cirrhosis is undergoing demographic changes due to the prevalence of overweight and obesity, and new emerging treatments for hepatitis C. However, limited evidence is available on the profile of cirrhosis in Germany. Researchers at the Goethe University Hospital Frankfurt led by Prof. Jonel Trebicka analyzed the data from the Federal Statistical Office of Germany of around 250 million hospital admissions in Germany from 2005 to 2018 and found that the number of hospital admissions due to cirrhosis has increased nationwide and its diagnosis as comorbidity doubles the mortality rate of other chronic diseases. This work was published on 4 November 2021 in The Lancet Regional Health - Europe.

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October 05, 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

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September 12, 2021 3rd DECISION General Assembly Meeting The 3rd DECISION General Assembly Meeting took place in Barcelona, Spain, on 8 – 10 September 2021 and reunited 54 researchers to discuss progress of the DECISION project

BARCELONA—The 3rd DECISION General Assembly Meeting was a three-day event where work package leaders presented major outcomes and milestones of the DECISION project.

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July 30, 2021 EF Clif initiates the Global CHANCE study to analyze the benefit of liver transplantation among patients affected by Acute-on-Chronic Liver Failure EF Clif, in collaboration with the European Society for Liver and Intestine Transplantation (ELITA) and the International Liver Transplantation Society (ILTS), launched the CHANCE study - Liver transplantation in patients with Cirrhosis and severe Acute-on-Chronic Liver Failure (ACLF): Indications and outcomes, a multicenter and international three-year study, of a prospective and non-interventional observational nature, in which over 2000 patients from 95 hospitals located in 27 countries will be recruited.

BARCELONA—The results obtained with the CHANCE study could contribute to the drafting of new protocols for clinical action for patients with different acute-on-chronic liver failure grades, improve the criteria for assigning organs to these patients, compare survival rates according to severity and establish the impact of liver transplantation on their quality of life.

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July 05, 2021 Two new centers join the EASL-Clif Consortium EF Clif announces the addition of two new centers to the EASL-Clif Consortium after the last annual meeting of the EASL-Clif Consortium Steering Committee

BARCELONA— The European Association for the Study of Chronic Liver Failure (EASL-Clif) Consortium is constituted by more than 300 clinical researchers in 116 university hospitals across 28 countries. Since its foundation in 2009, the EASL-Clif Consortium has been devoted to the advancement of knowledge on the pathophysiology, diagnostics, and treatment of cirrhosis.

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June 20, 2021 The EASL-Clif Consortium Steering Committee meets to discuss future scientific activities to be conducted under the umbrella of the EASL Chair The annual meeting of the EASL-Clif Consortium Steering Committee took place online on 15 June 2021

BARCELONA—The EASL-Clif Consortium was founded in 2009 with the aim to strengthen collaboration across Europe and further our understanding of advanced liver disease. Pioneering work by researchers and professionals in 106 centers in 26 European countries led to the description of acute-on-chronic liver failure (ACLF) – a syndrome that affects patients with cirrhosis characterized by acute decompensation, associated with organ failures and high short-term mortality.

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May 28, 2021 A SPECIAL ISSUE OF JOURNAL OF HEPATOLOGY COUNTS ON A GREAT PARTICIPATION OF RESEARCHERS OF THE EF CLIF FOUNDATION The issue is focused on decompensated cirrhosis and shows the most recent discoveries, which open new ways to treat and cure the disease

Cirrhosis has a huge impact in the quality of life of patients and the healthcare and economic systems. The EF Clif researchers have contributed to characterize and find the predictors and mechanisms involved in the development and clinical course of ACLF, which will help to prevent and treat ACLF in a near future.

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May 03, 2021 Cristina Sánchez appointed Head of the Data Management Center The Head of the Data Management Center is responsible for providing leadership and facilitating all aspects of the collection, handling, storage, and analysis of data for EF Clif studies

BARCELONA—Working closely with the Scientific Board and Scientific Coordinators, the DMC plays an important role in the design and development of the databases and protocols for all EF Clif studies, ensures good research data management, assists regional coordinator with protocol implementation, tracks specimen information, delivers remote training across study sites, and contributes to data analysis and manuscript preparation.

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March 20, 2021 Successful kick-off meeting of the H2020 project A-TANGO Researchers, experts and stakeholders from 14 partner organizations from academia, industry, and patient advocacy groups for liver disease in eight European countries met virtually on 17 March 2021 to discuss A-TANGO project goals, expectations and results to be achieved during the next five years

BARCELONA—Some patients with alcoholic liver disease develop alcoholic hepatitis which eventually results in multiorgan failure and death. End-stage liver disease may lead to acute-on-chronic liver failure (ACLF), a syndrome characterized by acute decompensation of cirrhosis, organ failures, and high short-term mortality. There is no specific treatment for patients with ACLF and management is based on organ support and liver transplantation. The A-TANGO project aims to address unmet clinical needs for patients with ACLF and improve patient survival rates by means of a novel combinatorial therapeutic strategy – G-TAK improves hepatocyte proliferation through granulocyte colony-stimulating factor (G-CSF) and reduces systemic inflammation by repurposing TAK-242, an antagonist of Toll-like receptor 4. A multicenter phase II clinical trial will be conducted to assess the effectiveness and therapeutic benefits of G-TAK.

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January 11, 2021 The CARBALIVE Consortium announces positive results of a Phase 2 equivalent trial of engineered macroporous carbons as a novel treatment for cirrhosis The CARBALIVE Consortium is focused on developing a novel treatment for patients with advanced liver disease. It is composed of partners from across Europe, led by University College London, and includes Yaqrit, a life sciences company and the intellectual property owner of Carbalive™ and the European Foundation for the Study of Chronic Liver Failure, among others.

The CARBALIVE Consortium has announced that the Phase 2 clinical trial has obtained positive data on efficacy of Carbalive™, a product candidate for the treatment of patients with decompensated cirrhosis.

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January 11, 2021 The ALIVER Consortium announces positive results from Phase 2 equivalent trial of the novel liver dialysis device, Dialive™ ALIVER is a consortium focused on developing a new treatment for patients with liver failure for whom there are no specific approved therapies, apart from liver transplantation. The Consortium is composed of partners from across Europe, led by University College London (UCL), and includes Yaqrit Ltd, a life sciences company and intellectual property owner of Dialive™, the European Association for the Study of the Liver (www.easl.com) and the EF Clif, amongst others.

The Consortium is developing and testing a novel blood filtration system, DIALIVE, whose design is based on 20 years of research led by Professor Rajiv Jalan, Professor Nathan Davies and members of the Liver Failure Group at UCL. Yaqrit Ltd was spun off from UCL in 2014 to develop and potentially commercialise treatments including Dialive™ for patients with advanced liver disease. Professor Jalan is the lead scientific founder of Yaqrit.

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November 17, 2020 UPDATED LIST OF PARTICIPANT HOSPITALS IN THE CHANCE STUDY More than 70 hospitals are willing to start the inclusion of the CHANCE study, which will compare survival rates after liver transplantation in patients with acute-on-chronic liver failure and transplant-free survival of patients within the same group.

Download list of CHANCE centers

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July 07, 2020 The EASL Clif Consortium raises its partners to 114 During the last meeting of the Steering Committee, 8 hospitals from Croatia, Germany, Greece, Italy, Luxembourg, Portugal, Switzerland and Turkey were chosen to be part of the EASL Clif Consortium

University Hospital Dubrava, led by Ivica Grgurevic; Charite University Hospital in Berlin, by Cornelius Engelmann; Laiko General Hospital of Athens, by George Papatheodoridis; Liver Unit. University of Verona, by Davide Sacerdoti; Centre Hospitalier de Luxembourg, by Verónica Prado; Hospital de Santa Luzia in Viana do Castelo, by Rogerio Corga; Università della Svizzera Italiana, by Roberto di Donato and Sakarya University School of Medicine, by Aydin Seref Köksal are the new members.

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June 04, 2020 The 2019 Summary of Activities of the EF Clif is ready for you The most relevant facts and information on the current and future research Project are in it

We want you to know us and our partners better. We are proud of the research projects on going and the ones that are coming.

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May 05, 2020 The EF Clif leads the REP COVID Study This is a Phase II Clinical Trial aimed at assessing the impact of plasma exchange with 5% albumin in patients with COVID-19 disease and invasive mechanical ventilation

The trial is endorsed by the EF Clif and has engaged four hospitals in the area of Barcelona: Hospital Clinic, Hospital de Bellvitge, Hospital del Mar and Hospital Germans Trias i Pujol.

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April 16, 2020 The EF Clif leads the DECISION Project, aimed to design a systemic treatment to cirrhotic patients the end stage of the disease The DECISION project is a Horizon 2020 funded research, whose overall aim is to prevent ACLF and drastically reduce mortality rates in patients with decompensated cirrhosis

For the next 5.5 years, Prof Pierre-Emmanuel Rautou will coordinate 21 relevant European institutions to analyse and integrate data and biological samples from 2,000 patients, validate the results in animal models and test the most promising resultant therapy in a phase II clinical trial.

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February 13, 2020 Prof Rajiv Jalan, new Scientific Director of the EF Clif Prof Jalan's candidacy has been chosen to develop the new position of Scientific Director in the EF Clif due to his extensive experience in Hepatology research -particularly in cirrhosis- and his relevant and consolidated track record of publications worldwide.

He also has vast expertise in leading collaborative international projects such as the EU H2020 ALIVER and CARBALIVE. Together with Prof. Vicente Arroyo, Director of the EF Clif, they will lead the Strategic Research Program of the Foundation.

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October 21, 2019 The 1st EF Clif Venice Meeting on ACLF was a great success. As a part of the events for the celebration of the Clif Consortium 10th anniversary, the EF Clif organized the 1st EFClif Venice Meeting on October 18-19, 2019

In the premises of the Fondazione Cini, a small island in front of the world famous Piazza San Marco, the most active members of the Clif Consortium and other outstanding researchers from around the world attended the two-day Symposium entitled "The Acute-on-Chronic Liver Failure syndrome in cirrhosis".

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October 01, 2019 Dr Giacomo Zaccherini, new Visiting Fellow at the EF-Clif Dr Zaccherini is a Research Fellow in hepatology of the University of Bologna and carries out his clinical activity at the S.Orsola-Malpighi University Hospital

He has joined the EF Clif to conduct a research on the characteristics of different organ failures in patients with acutely decompensated cirrhosis, using the metabolomics data from the CANONIC Study cohort, under the auspices of the Grifols Chair during the next 6 months.

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September 02, 2019 Dr Emmanuel Weiss joins the EF Clif thanks to the CELLEX Program for Young Researchers The Cellex grant will give Dr Weiss the opportunity to stay in Barcelona as a Visiting Professor during a year

Dr Weiss is a member of the Anesthesiology and Critical Care Unit in Hôpital Beaujon in Clichy (France) and an Associate Professor in Liver and Digestive ICU at the same hospital. He has specialized in innate immune response and organ failure of patients with liver disease. He is also young editor of Intensive Care Medicine, the Journal of the European Society of Intensive Care Medicine.

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June 20, 2019 THE EASL-CONSORTIUM CELEBRATES THIS 10TH ANIVERSARY On June 11th, 2019, we celebrated the 10th anniversary of the foundation of the Clif Consortium.

The signature of the first collaboration agreement between Grifols and the Fundació Clínic per la Recerca Biomédica (FCRB, participated by the Universitat de Barcelona and the Hospital Clínic) on June 11th, 2009, provided the grounds and funds to establish an initial consortium constituted by 70 University Hospitals from all across Europe.

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April 23, 2019 The EASL Clif Consortium participated in the International Liver Congress 2019 The ILC took place 10-14 April 2019 in Vienna with the attendance of around 10,000 delegates from more than 121 countries.

Most of the EASL Clif Consortium centres were represented and active in the Congress. Thanks to the daily work of the Consortium members, the quality of their contributions in oral presentations, posters and a Think Tank on Chronic Liver Failure were highly appreciated and commented during the meeting.

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January 31, 2019 The Microb-Predict Project is already running! The kick off meeting gathered for three days in a nice venue with astonishing sea views all the researchers who participate in the Microb-Predict project

During the several working sessions, more than 60 people including clinicians, molecular scientists, bioinformaticians, data managers and nurses, discussed about the different work-packages and milestones, in an attempt to perfectly coordinate the work of the 22 institutions which are part of the project.

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November 26, 2018 THE ACLARA STUDY IS ALREADY RUNNING First inclusions in the Aclara Study

The first inclusion week of the Aclara study finished with two new patients recruited in Hospital das Clinicas of Sao Paulo University.

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November 07, 2018 LAST WEEK WE CELEBRATED THE 2ND ACLARA WORKSHOP IN MEXICO CITY The workshop, which was a great success, took place in the Auditorium of the Clínica Médica Sur in Mexico DF, under the patronage of Dr Misael Uribe

24 professionals from Brazil, Colombia, Panama, Mexico and Peru attended the sessions On 30th and 31st of October 2018 where they were trained in the Management of samples, completion of the eCRF and use of the Clif-Consortium scores.

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October 12, 2018 FIRST TRAINING WORKSHOP FOR THE PARTICIPANTS IN THE ACLARA STUDY The workshop was held on 1st and 2nd October 2018 at the Faculty of Medicine of the USP in Sao Paulo, with the participation of specialists from Argentina, Brazil and Chile

The first session served as an introduction to the management of the samples, followed by onother one focused on the protocol guidelines and the use of the Clif-Consortium scores

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October 04, 2018 THE PRINCIPAL INVESTIGATORS OF THE ACLARA STUDY MET DURING THE ANNUAL ALEH CONGRESS 23 PIS participated in the work session on 21st September in Punta Cana, where they shared their views and prospects on the current state of the Project.

The discussion was focused on coordinating the efforts into reaching common act policies. Headed by the PIS of the Study, Dr Flair Carrilho, Dr Vicente Arroyo and Dr Richard Moreau and with the assistance of Dr Alberto Q Farias, the Study coordinator, the meeting was also instrumental to work further on different technical aspects and establish further guidelines of the ACLARA STUDY.

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June 18, 2018 PARTICIPANTS LIST OF THE ACLARA STUDY At the moment, more than 50 hospitals are part of the Study, which will lay the foundations to caractherize the specificities of the ACLF in Latin America and then to have a global vision of the syndrome.

The last member to join the project has been Hospital de las Clínicas de Asunción (Paraguay) in December '18.

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May 01, 2018 New visiting researcher at the EF Clif Dr Wenyi Gu, medical investigator working on the group of Dr Hai Li in Shanghai, is spending three months at the EF Clif central headquarters in Barcelona.

Dr Wenji Gu is a medical investigator, currently finishing her Master at the Department of Gastroenterology in Ren Ji Hospital, School of Medicine, and at Key Laboratory of Gastroenterology & Hepatology in Shanghai Jiao Tong University.

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April 18, 2018 Anna Bosch has been appointed Managing Director of the EF Clif Anna Bosch holds a PhD with a doctoral thesis in molecular genetics and developed translational research on diabetes during several years, between the Genetics Department of the University of Barcelona and the Tumor and Biology Centre in the Karolinska Institute, Sweden. In 1998 she incorporated to the IDIBAPS to create the biobank of the Esther Koplowitz Medical Research Center at the Hospital Clinic Campus. Subsequently her responsibilities extended to other biobanks of the Campus and scientific core facilities including genomics, bioinformatics and biostatistics, flow cytometry, cerebral imaging through MRI and P3 laboratory.

The change is aimed to prepare the Foundation to major challenges coming in the near future, including a significant increase in the number of projects and funds, the participation of the Foundation in EU grants and the incorporation of high throughput omics technology in most observational studies and projects.

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April 16, 2018 NEWS FROM THE EASL CLIF CONSORTIUM GENERAL ASSEMBLY AND STEERING COMMITTEE During the EASL International Liver Congress 2018 at Paris, the EASL Clif Consortium held the Annual General Assembly and the Steering Committee meeting

More than 80 investigators of the EASL Clif Consortium took part in the Assembly where the speakers gave a comprehensive overview of the latest researches in the setting of EF Clif and had the opportunity to exchange experiences.

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February 07, 2018 Welcome to Paolo Angeli as the new Chairman of the EASL-CLIF Consortium The EF Clif organized an international meeting at the foundation headquarters, on February 7th 2018, to welcome Paolo Angeli as the new Chairman of the EASL-Clif Consortium (January 1st 2018)

Among the participants, there were most Steering Committee Members of the EASL-CLIF Consortium, a selected group of investigators from the PREDICT Study, the Principal Investigators of the 2018 research program of the EF Clif, members of the Grifols Chair, Dr Tom Henning Karlsen, EASL General Secretary, Professors Roger Williams and Flair Carrilho

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November 28, 2017 THE EF CLIF IS EXPANDING ITS DATA MANAGEMENT CENTER BY HIRING A DATA ANALYST AND A DATA MANAGER We are looking for two professionals to join our Data Managent Center at our headquarters in Barcelona.

The incorporation for both candidates is foreseen during the first quarter of 2018

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November 13, 2017 NEWS FROM THE GRIFOLS CHAIR #3 Addressing patients' diversity in acutely decompensated cirrhosis Richard Moreau, Joan Clària and Vicente Arroyo

The CANONIC study has shown that among patients with acute decompensation (AD) of cirrhosis, those who had Acute-on-Chronic Liver Failure (ACLF, characterized by intense systemic inflammation, organ failures and poor outcome) were clearly distinct from those with traditional AD (who do not have organ failures and have good outcome).

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