EFCLIF-AR-2024

ANNUAL REPORT 2024

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Scientific publications and communications

Supporting independent investigator-led research and innovation

Research outputs

A digital solution to streamline clinical decision-making

Partnership to explore specific targeted treatments for ACLF

Driving strategic collaborations to advance chronic liver disease research and treatment

AI-driven models to transform liver allocation across Europe

Defining transplant futility in severe ACLF – A global perspective

Taking bold steps to improve graft allocation policies

Advancing combinatorial therapies for alcohol-related liver disease and ACLF

New clinical trial explores combination therapy to reduce complications in decompensated cirrhosis

Personalizing albumin treatment in cirrhosis and ascites through biomarker validation

Carbon beads to restore gut microbiome and slow liver disease progression

Laying the groundwork for microbiome-based biomarkers in clinical practice

Predictive tools for personalized management in advanced chronic liver disease

A new animal model for advanced MASH-cirrhosis

Unraveling immune dysfunction in cirrhosis

Highlights of the year

Statement from our General Manager

Statement from our Director

The path forward

We are shaping the future of chronic liver disease

Our foundations and purpose

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Revolutionizing the landscape of chronic liver disease

Our progress

Our world-class research network

Contents

Why the study of chronic liver disease matters

Importantly, precipitating events associated with short term mortality among patients withACLF are not reflected in the conventional prognostic models for organ allocation falling short in prioritizing most severe patients with decompensated cirrhosis for liver transplantation. The alarming increase in obesity rates, harmful use of alcohol, and an aging population mean that liver disease will become an even greater global health concern over the next decade. Experts agree that the major causes of liver disease (i.e., alcohol-related liver disease, metabolic dysfunction-associated steatotic liver disease, and viral hepatitis) are amenable to prevention and treatment providing an opportunity to reduce the burden of liver disease and save lives. There is an urgent need to engage with policymakers and health authorities to invest in preventive actions and surveillance as regards chronic liver disease.

leading cause of cirrhosis globally

Alcohol

Harmful use of alcohol

CIRRHOSIS

Leading causes of

HBV & HCV infections

Overweight and obesity

Cirrhosis is

leading cause of DALY

15th

leading cause of deaths worldwide

11th

2,

deaths worlwide due to liver disease

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Because cirrhosis is a progressive disease, efficient treatment and management of patients with chronic liver disease are essential to improve patients’ survival rates and reduce the socioeconomic impact of the disease. It is remarkable to note that there have been no new, disease-modifying approaches to the treatment of chronic liver disease. Liver transplantation is the one treatment that has shown promise in improving patient survival by restoring essential functions where no alternative treatment of comparable effectiveness exists even for patients with severe acute-on-chronic liver failure (ACLF). A system for organ allocation that ensures equitable distribution continues to be an unmet medical need for patients with cirrhosis, and particularly those who progress into ACLF.

Why the study of chronic liver disease matters

To achieve this, we: Provide financial support for chronic liver disease research projects.Encourage participation in competitive research and innovation initiatives focused on translational advancements to improve clinical practice and early diagnosis.Develop and promote programs and activities to train healthcare professionals and researchers.Foster the dissemination of new knowledge about chronic liver disease. Guided by our mission and reflected in our current strategy, we advance knowledge and facilitate the translation of research into clinical practice, striving to improve care and enhance the quality of life for patients with chronic liver disease.

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By funding and supporting cutting-edge research, we contribute to advance the understanding of chronic liver disease, develop lifesaving treatments, and improve patient care.

Our work goes beyond research—we engage with healthcare professionals, policymakers, scientists, and patients to drive innovation, inform clinical practice, and advocate for equitable access to care. Together, we aim to transform how chronic liver disease is managed, making a lasting impact for individuals, families, and communities worldwide. Our bylaws, as of 2015, state that our purpose is “to design, support, promote, and lead biomedical research studies and projects at a supranational level in the field of Health Sciences, particularly in the area of chronic liver failure”.

Our foundations and purpose

The path forward

The journey into our vision will be guided by: Supporting collaborative projects, providing resources for high-impact research, and cultivating a culture of shared expertise and mentorship within the chronic liver disease research community. Conducting large-scale multicenter studies, partnering with international stakeholders, engaging liver patient communities, and advising policymakers on evidence-based standards and protocols.

We envision a thriving network of researchers and healthcare professionals across Europe, united in their pursuit of advancing knowledge on cirrhosis and its complications.

We are shaping the future of chronic liver disease

Fostering cross-disciplinary collaboration, facilitating global knowledge exchange, and investing in the development and evaluation of innovative therapeutic and diagnostic solutions.

We aspire to be a reference in driving innovation for the diagnosis, prognosis, and treatment of cirrhosis and acute-on-chronic liver failure. Our vision is a future where advanced tools and novel therapies significantly improve patient outcomes and quality of life.

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Our vision is to establish a global standard of care for decompensated cirrhosis and acute-on-chronic liver failure, informed by cutting-edge research and multidisciplinary collaboration.

Our global network of tertiary care hospitals, universities, and research centers brings together over 1,000 laboratory-based researchers, consultant physicians, intensivists, surgeons, nurses, and pathologists to carry out groundbreaking chronic liver disease research, ranging from translational studies to large-scale clinical trials.

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The Global Projects chapter offers the framework to promote research in cirrhosis around the world and brings the opportunity to strengthen connections between healthcare professionals across geographical borders.

The Grifols Chair promotes translational studies in centers across Europe and North America within the framework of the European Network for Translational Research- Chronic liver failure (ENTR-CLIF). Leading researchers and highly qualified scientists at these centers help moving scientific discovery from the laboratory to patients faster.

Through the large-scale observational studies we fund, these centers contribute to help drafting clinical practice guidelines that improve healhtcare and patients' outcomes. The European Association for the Study of the Liver (EASL)-Chronic Liver Failure (CLIF) Consortium also provides the framework to initiate new research ideas and programs, and offers the next generation of scientists and research leaders unique opportunities to drive future research and innovation in the area of liver disease.

96 centers in 22 countries

23 centers in 7 countries

120 centers in 29 countries

Global projects

ENTR-CLIF

EASL-CLIF Consortium

Our network

Find out more about the EF CLIF database

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Our research environment

Our progress

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A new collaboration with GENFIT, a biopharmaceutical company developing treatments for acute-on-chronic liver failure (ACLF), led to the launch of a translational research program coordinated by Joan Clària (who serves as Head of Translational Operations) to evaluate the effectiveness of novel therapies in animal models. A major initiative in clinical research was also launched under the leadership of Paolo Angeli, Chair of the EASL-CLIF Consortium (our clinical research chapter). This initiative involves the design of a large European observational study that will explore the clinical course of patients with compensated cirrhosis and better characterize the types of decompensation episodes, which remain poorly understood. The study protocol will be available soon. We at EF CLIF, through the EASL-CLIF Consortium, are actively engaging with professional societies and consortia—including AASLD, APASL, ALEH, and Baveno—to align diagnostic criteria for organ

This year’s report highlights new initiatives that reflect our continued commitment to advancing care for patients with chronic liver disease.

In 2024, we introduced several key changes in our governance and scientific structure. Jonel Trebicka was appointed Deputy Director, reinforcing leadership in both clinical and research areas. A new Governing Board was established, bringing together nine members who represent a broad spectrum of clinical and translational research expertise. The board is tasked with advising the Director and General Manager on internal matters and strengthening our relationships with stakeholders. The Foundation’s Scientific Advisory Board also saw changes, with Jonel Trebicka named Chair and Salvatore Piano appointed Secretary. This board, composed of internationally recognized scientists, plays a vital role in providing annual assessments of our scientific output. The Inspiring Writing Group welcomed new early-career researchers, who participated in a productive initial meeting, highlighting our commitment to nurturing the next generation of scientific leaders.

Statement from our Director

Our progress

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Prof. Richard MoreauDirector of EF CLIF

The second, conducted in collaboration with researchers in Shanghai, revealed that disruptions in all three major types of immune responses are associated with progression to ACLF. Last but not least, the first publication from the DECISION Consortium, analyzed clinical data from the CANONIC, PREDICT, and ACLARA studies to identify distinct subgroups among patients with acutely decompensated cirrhosis using a clustering strategy. Our researchers also contributed to a consensus statement developed with APASL on the management of acute kidney injury in patients with ACLF. This publication reflects the growing global effort to create a common language and shared clinical guidelines for managing decompensated cirrhosis. I am excited about the future of EF CLIF as we begin a new chapter in 2025 with the relocation of our headquarters in Barcelona.

failures and support a shared understanding of chronic liver disease definitions. In addition, Javier Fernández (who serves as Head of Clinical Operations) was invited to set up a network of intensive care specialists focused on patients with cirrhosis who require critical care. The goal is to support studies specifically designed for intensive care unit settings and improve care for this vulnerable population. This year, we have seen several important advances across our research and collaboration efforts, with a few key developments standing out in particular. Firstly, findings from our reserchers demonstrating how human albumin can help correct immune dysfunctions in decompensated cirrhosis, specifically in B cells and neutrophils.

With strong leadership and a dedicated team, I am confident that this move will position us for even greater success, allowing us to strengthen our impact and continue making significant strides in the field of chronic liver disease research and care.

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Our progress

New predictive models and biomarker tools developed by our investigators are helping lay the foundation for safe and effective treatment strategies. Through the CHANCE study, we are contributing to the body of evidence on transplant futility in severe ACLF, prompting discussion on graft allocation policies across Europe and beyond. In addition, our team at the EF CLIF Data Management Center has played a central role in supporting clinical operations and ensuring data quality across our multicenter trials. These achievements are often less visible, yet they are essential to the success of all our research initiatives.

Driving innovation in research and clinical practice

reflects the growing relevance of our work and our ability to engage with key stakeholders both from the public and private sectors.

Across our network, we have worked with dedication and purpose, reinforcing our commitment to supporting clinical and translational research through collaboration.

In 2024, we have made important progress in advancing knowledge to improve care and quality of life for patients with chronic liver disease. As coordinators of the ongoing EU-funded projects MICROB-PREDICT, DECISION, and A-TANGO, we take pride of the progress made over the year that has led to the the validation of prognostic tools and the start up of new clinical trials aimed to achieve personalize management of patients with chronic liver disease. These efforts are a direct result of sustained multidisciplinary collaboration across consortium participants, with contributions from clinicians, scientists, data managers, and patient representatives. A significant milestone this year was the establishment of a strategic partnership with GENFIT, focused on developing innovative and personalized treatment options for patients with acute-on-chronic liver failure (ACLF). This collaboration

Statement from our General Manager

Our progress

Looking ahead

The first months of 2025 have already seen the launch of several initiatives that will shape EF CLIF’s future direction. Our new headquarters in Barcelona is now fully operational, offering a space that fosters collaboration and growth. I take pride on the other initiatives to be launched throughout the year, like our very own Master program on hepatology research, which marks an important step in

Strengthening communication and outreach

Throughout the year, we have continued to invest in communication and outreach initiatives, with the aim of making our work more accessible to patients, clinicians, and the broader scientific community. By translating complex findings into practical insights, we hope to support better decision-making and foster greater understanding of chronic liver disease.

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Dr. Anna BoschGeneral Manager

strengthening our educational mission and engaging the next generation of researchers and professionals in the field. Moreover, we have recently welcomed eight new junior members to the Inspiring and Writing Group to address unmet medical needs in cirrhosis, intensive care management and liver transplantation through collaborative projects. We are also celebrating 10 years of the Grifols Chair, a collaboration that continues to serve as a foundation for high-impact translational research. As part of this anniversary, we have renewed the framework agreement between EF CLIF and Hospital Clínic de Barcelona-Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), ensuring continuity in our mission to accelerate scientific discovery and improve clinical outcomes for people living with chronic liver disease.

Finally, we are preparing for the Mother of All Protocols study, which seeks to harmonize and streamline data collection across large-scale studies. This initiative reflects our long-term commitment to improving the infrastructure of liver research in Europe and beyond. We at EF CLIF are deeply grateful to all those who contribute to our shared progress. As we move forward, we remain firmly committed to advancing scientific discovery, redefining clinical practice through collaborative research, and working together to improve care and outcomes for people living with chronic liver disease.

from donations

We raised over

€1.34 m

Highlights of the year

Our progress

across social media channels

Click on interactive elements to read more.

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We welcomed

300 followers

media appearances - that we know of

We made

in EU funding

We received

€750,000

by independent researchers

We enabled

8 new ancillary studies

We participated in

11 scientific events

12 of these in open access journals

We published

15 papers

Currently, we fund

1 large-scale observational study

Read more on our website

the study revealed that albumin reprograms immune cells, strengthening antimicrobial responses. These findings suggest that albumin’s benefits extend beyond fluid management, opening new possibilities for improving outcomes in immunocompromised patients.

Boosting immune defence with albumin

New research shows that albumin enhances B cell and neutrophil function, helping to reduce infection risk in patients with acutely decompensated cirrhosis. Using single-cell RNA sequencing,

Research this year has advanced our understanding of immune dysfunction in cirrhosis, shedding light on its role in disease progression and its complications. From albumin’s immune-boosting effects to insights into distinct immune cell profiles and metabolic alterations, these findings shed new light on the intricate interplay between inflammation, immune dysregulation, and decompensated cirrhosis. This knowledge paves the way for novel biomarkers and therapies to improve outcomes in chronic liver disease.

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Unraveling immune dysfunction in cirrhosis

Revolutionizing the landscape of chronic liver disease

Read more on our website

Immunometabolic signatures as predictors of ACLF recovery

A study identified distinct immunometabolic signatures in monocytes that predict recovery or non-recovery in ACLF. Patients who recovered exhibited anti-inflammatory profiles, while those with poor outcomes showed increased expression of inflammatory and stress-response genes. These findings provide new insights into ACLF pathophysiology, highlighting systemic inflammation and immune dysfunction as potential therapeutic targets to improve survival in this severe condition.

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Revolutionizing the landscape of chronic liver disease

Read more on our website

Read more on our website

Immune signatures predict risk of ACLF

Role of fatty acid metabolism on immune dysfunction in chronic liver disease

Research identified elevated palmitoylcarnitine in acutely decompensated cirrhosis as a key driver of mitochondrial dysfunction and immune cell impairment. This metabolite triggers oxidative stress and inflammation, further disrupting immune regulation. Blocking palmitoylcarnitine metabolism or using albumin to mitigate its effects showed promise for new therapeutic strategies. These findings point to immunometabolism as a new frontier for innovation in cirrhosis treatment.

A large cohort study showed that immune dysfunction in acutely decompensated cirrhosis plays a critical role in the progression to ACLF. Reduced type-1 immune responses, increased type-2 and type-3 cytokines, and changes in white blood cell production are linked to worse outcomes. These findings shed light on the immune system imbalances that drive severity of the disease, opening up new opportunities for developing biomarkers and targeted therapies to prevent ACLF.

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Revolutionizing the landscape of chronic liver disease

This project has received funding from the European Union’s Horizon 2020 research and innovation programme under grant agreement no. 847949.

Read more on our website

Within the EU-funded DECISION project, researchers developed a new animal model to accelerate the study of advanced metabolic dysfunction-associated steatohepatitis (MASH), a severe condition that leads to cirrhosis. This model improves on existing ones by replicating advanced fibrotic stages and cirrhosis in just 6–8 weeks. By combining carbon tetrachloride (CCl4), a high-fat Western diet, and phenobarbital, the rat model mimics key features of human MASH-cirrhosis, including liver fibrosis and portal hypertension. This advancement could speed up drug discovery, potentially leading to more effective treatments for patients with MASH-cirrhosis.

A new animal model for advanced MASH-cirrhosis

Revolutionizing the landscape of chronic liver disease

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Read more on our website

Revolutionizing the landscape of chronic liver disease

Advancing personalized care with ClustALL stratification

ClustALL, a novel computational tool, was developed within the EU-funded DECISION project to advance personalized care for patients with acutely decompensated cirrhosis by identifying distinct subgroups based on clinical features and outcomes. The tool identified three clusters with distinct prognoses, highlighting the importance of biomarkers such as serum bilirubin and INR in patient stratification. Unlike traditional methods, ClustALL accounts for data variability, enabling precise subgroup identification for improved trial designs and treatments. Complementing existing prognostic scores, ClustALL offers valuable insights into patient heterogeneity and supports clinicians through an online calculator. Future updates may incorporate biological data and customizable features to expand its clinical applications.

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Advanced chronic liver disease presents challenges in personalized care, particularly in predicting complications like cancer and managing patient variability. Newly developed cutting-edge tools – ClustALL and the PLEASE score – offer innovative solutions to address these challenges, improving patient stratification and disease risk assessment. These advancements could pave the way for tailored management strategies that enhance outcomes and streamline healthcare delivery for patients with complex chronic diseases.

Predictive tools for personalized management in advanced chronic liver disease

Read more on our website

This project has received funding from the European Union’s Horizon 2020 research and innovation programme under grant agreement no. 847949.

A new algorithm, the PLEASE score, was developed to help clinicians personalize screening schedules for patients with advanced chronic liver disease, improving early detection of hepatocellular carcinoma (HCC). The study identified key risk factors, including liver stiffness, platelet count, age, sex, and liver disease etiology. Patients scoring four or more points were classified as high risk and recommended for frequent screening, while low-risk patients could avoid unnecessary tests. By tailoring surveillance intervals, the PLEASE score reduces healthcare burdens and puts resources on those at greatest risk. This innovative approach offers a path to better HCC outcomes by facilitating earlier diagnosis and more efficient patient management.

Predictive tools for personalized management in advanced chronic liver disease

Revolutionizing the landscape of chronic liver disease

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Read more on our website

This project has received funding from the European Union’s Horizon 2020 research and innovation programme under grant agreement no. 946590.

Key recommendations included adopting international standards, raising awareness, fostering interdisciplinary collaboration, and aligning research with clinical needs. Under the umbrella of the newly established European Microbiome Centres Consortium (EMCC), a growing network of microbiome research institutions will drive translational innovations with the potential to transform preventive nutrition and healthcare.

Advancing microbiome-based biomarkers into clinical practice requires consensus and collaboration, yet a lack of validated analytical methods and standardization remains a major barrier. To address this, the EU-funded International Human Microbiome Coordination and Support Action conducted a Delphi survey, gathering expert insights on how to overcome these challenges. The survey highlighted the transformative potential of microbiome-based biomarkers in revolutionizing diagnostics and treatment monitoring but emphasized the need for greater consistency and comparability in microbiome clinical studies.

Laying the groundwork for microbiome-based biomarkers in clinical practice

Revolutionizing the landscape of chronic liver disease

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Read more on our website

This project has received funding from the European Union’s Horizon 2020 research and innovation programme under grant agreement no. 634579.

The CARBALIVE-SAFETY clinical trial confirmed the beads' safety with minimal side effects. With further trials underway, researchers hope these beads could provide a new therapeutic approach for liver disease and other conditions linked to gut dysbiosis.

Within the EU-funded project CARBALIVE, researchers investigated the safety and efficacy of carbon beads licensed to Yaqrit, a University College London spinout, for treating liver disease. Yaq-001 beads showed promise in animal models by restoring the gut microbiome and improving liver, kidney, and brain function. In rats and mice with induced cirrhosis and acute-on-chronic liver failure (ACLF), daily ingestion of the beads prevented liver scarring, reduced mortality, and promoted gut health. Yaq-001 works by absorbing harmful molecules like endotoxins and toxic metabolites, reducing gut inflammation and protecting organs from damage.

Carbon beads to restore gut microbiome and slow liver disease progression

Revolutionizing the landscape of chronic liver disease

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Read more on our website

This project has received funding from the European Union’s Horizon 2020 research and innovation programme under grant agreement no. 825694.

The ALB-TRIAL, carried out within the EU-funded MICROB-PREDICT project, began patient recruitment in early 2024. This multicenter clinical trial aims to validate a predictive panel of microbiome-based biomarkers to guide the personalized use of long-term human albumin therapy in patients with cirrhosis and ascites. By tailoring treatment strategies, the trial seeks to improve outcomes while reducing unnecessary interventions. The involvement of the European Liver Patient’s Association (ELPA) ensures the study design reflects patient priorities.

Personalizing albumin treatment in cirrhosis and ascites through biomarker validation

Revolutionizing the landscape of chronic liver disease

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Read more on our website

This project has received funding from the European Union’s Horizon 2020 research and innovation programme under grant agreement no. 847949.

As part of the DECISION project, the COMBAT trial started up to test the combination of human albumin and low-dose enoxaparin in patients with decompensated cirrhosis. With the first patient enrolled in France, the study spans multiple European centers and is coordinated by our partner University of Bologna with the support from the EF CLIF Data Management Center. This trial could redefine treatment strategies and reduce hospitalizations, improving outcomes for patients with advanced cirrhosis.

New clinical trial explores combination therapy to reduce complications in decompensated cirrhosis

Revolutionizing the landscape of chronic liver disease

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This project has received funding from the European Union’s Horizon 2020 research and innovation programme under grant agreement no. 945096.

Read more on our website

In 2024, the A-TANGO Consortium completed preparations for the launch of its phase 2 clinical trial, which will evaluate safety and efficacy of a novel combinatorial therapy for alcohol-related liver disease and acute-on-chronic liver failure (ACLF). The trial is based on a drug repurposing strategy and targets two key pathways involved in disease progression: white blood cell proliferation and inflammation. The combination of G-CSF and TAK-242 aims to enhance host defense mechanisms while modulating excessive immune activation. This therapeutic approach addresses a critical unmet need in a population with limited treatment options and high short-term mortality.

Advancing combinatorial therapies for alcohol-related liver disease and ACLF

Revolutionizing the landscape of chronic liver disease

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Read more on our website

CHANCE calls for equitable access to liver transplantation

Presented at EASL Congress 2024, the CHANCE study exposes the barriers in current liver transplant allocation for patients with severe ACLF. Interim results revealed high mortality rates among patients with ACLF on transplant waitlist and significant regional disparities in post-transplant survival. These findings highlight the need to revise allocation policies, ensuring critically ill patients receive timely and equitable access to transplantation.

Two major initiatives, the CHANCE study and the EU-funded project LEOPARD, highlight the urgent need for better liver transplant allocation policies. The CHANCE study examines critical gaps in current transplant criteria for patients with severe acute-on-chronic liver failure (ACLF), emphasizing the need to redefine transplant futility and improve patient prioritization. Meanwhile, the LEOPARD project is leveraging AI-driven models to refine liver allocation across Europe, aiming to improve patient stratification and transplant outcomes. These efforts mark significant strides towards reducing waitlist mortality and improving liver transplantation practices.

Defining futility in severe ACLF – A global perspective

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Taking bold steps to improve graft allocation policies

Read more on our website

The CHANCE study entered phase 2 to establishing clear criteria for transplant futility in severe ACLF. Researchers aim to define the minimum survival thresholds both for graft and patient survival following liver transplantation in ACLF grade 3 cases with three or more organ failures. Building on phase 1 survival data, this phase seeks to refine predictive factors for survival, laying the groundwork for a new prognostic model that guides transplant decision-making and maximizes patient outcomes.

Defining liver transplant futility in severe ACLF: A CHANCE study update

Taking bold steps to improve graft allocation policies

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Read more on our website

This project has received funding from the EU's Horizon Europe program under grant agreement no. 101080964.

The EU-funded LEOPARD project is set to revolutionize liver transplant allocation through artificial intelligence. By integrating omics and radiomics data, LEOPARD’s AI-driven models are expected to improve risk assessment and patient prioritization, reducing waitlist mortality and harmonizing allocation policies across Europe. With a multi-year strategy for data collection, modeling, and validation, this initiative holds the potential to transform outcomes of liver transplantation in patients with chronic liver disease and ensure a more equitable allocation system.

AI-driven models to transform liver allocation across Europe

Taking bold steps to improve graft allocation policies

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Read more on our website

New partnership to advance ACLF research and treatment

EF CLIF has partnered with GENFIT to explore new therapeutic strategies for acute-on-chronic liver failure (ACLF). This collaboration aims to address the complexities of ACLF and improve patient outcomes. During EASL Congress 2024, both organizations presented their commitment to precision medicine, focusing on molecular signatures, predictive biomarkers, and emerging treatment targets for ACLF. The partnership promotes collaboration among key stakeholders, including international patient associations, regulators, and professional associations, marking a significant step forward in chronic liver disease research.

Recent collaboration with GENFIT and with Fundación Ibercaja emphasize the crucial role of strategic partnerships in advancing research and treatment for chronic liver disease. These initiatives highlight the importance of combining cutting-edge drug development and innovative digital solutions to improve patient outcomes. These efforts contribute to enhancing precision medicine, streamlining clinical decision-making, and fostering collaborative research, ultimately driving impactful advancements in the management of chronic liver disease.

Partnership to explore specific targeted treatments for ACLF

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Driving strategic collaborations to advance chronic liver disease research and treatment

Read more on our website

EF CLIF hosted GENFIT representatives in Barcelona to discuss progress on a joint project developing novel treatments for ACLF. This collaboration leverages the expertise of both organizations, advancing chronic liver disease research and reinforcing our shared commitment to improving patient care at the global level.

Harnessing expertise to accelerate development of targeted therapies for ACLF

Driving strategic collaborations to advance chronic liver disease research and treatment

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Read more on our website

EF CLIF has partnered with Fundación Ibercaja to develop a digital tool designed to improve decision-making in chronic liver disease. This collaboration focuses on creating a centralized platform that automates the calculation of medical scores using real-time patient data, improving clinical workflows. The tool will reduce errors, increase accuracy, and support healthcare professionals in making faster, more informed decisions, ultimately improving patient care and outcomes in the management of chronic liver disease.

A digital solution to streamline clinical decision-making

Driving strategic collaborations to advance chronic liver disease research and treatment

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Validation the effectiveness of the COSSH-ACLFcriteria and prognostic score in non-Asian ACLF populations PI: Jun Li, Zhejiang University School of Medicine, China Can replacing the whole blood cell count with neutrophil to limphocyte ration improve the predictive performance of the CLIF-C AD score? PI: Maria Papp, University of Debrecen, Poland Subphenotypes of patients with cirrhosis and sepsis PI: Marijke Peetermans, UZ Leuven, Belgium

These contributions reflect our role as a catalyst for innovation, providing high-quality resources that allow researchers at all career stages to explore new hypotheses, validate findings, and develop translational insights. Indepent investigator-led ancillary studies approved by the Sample and Data Usage Committee in the year ended 31 December 2024 are: Evaluation of factors defining the natural history and response to therapy of patients hospitalized with an acute episode of hepatic encephalopathyPI: Maria Pilar Ballester, Hospital Clínico Universitario de Valencia, Spain

In line with our commitment to advancing scientific knowledge and promoting collaboration, we actively support independent investigator-led research. This includes granting access to data and biospecimens from our flagship studies (namely, CANONIC, PREDICT, ACLARA, and CHANCE), enabling the development of ancillary projects that extend the impact of our research. In 2024, this support facilitated eight new studies across Europe and Asia, focusing on the pathophysiology of chronic liver disease.

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Supporting independent investigator-led research and innovation

Research outputs

Research outputs

Clonal hematoposieses as a predictor of the clinical course of patients with acutely decompensated cirrhosisPI: Emmanuel Weiss, Centre de recherche sur l'inflammation UMR 1149, France

HDL-based prognostic models for prediction of short-term survival in acutely decompensated cirrhosis PI: Rudolf Stauber, Medical University of Graz, Austria Task 6 in MICROB-PREDICT : Address geographic and gender differences, aging and effects of drugs in the progression of liver diseases PI: Jonel Trebicka and Wenyi Gu, University Hospital Münster, Germany

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Open Access Decompensated MASH-cirrhosis model by acute and toxic effects of phenobarbital Cells 2024, 13(20): 1707 DOI: 10.3390/cells13201707

Open Access Clinical, experimental and pathophysiological effects of Yaq-001: a non-absorbable, gut-restricted adsorbent in models and patients with cirrhosis Gut 2024 DOI: 10.1136/gutjnl-2023-330699

Our scientific dissemination strategy spans peer-reviewed publications, conference proceedings, and presentations at leading international meetings. These outputs reflect our ongoing commitment to sharing results with the scientific community as soon as possible, promoting transparency, and fostering dialogue across disciplines.

Research outputs

Open Access Palmitoylcarnitine impairs immunity in decompensated cirrhosis JHEP Rep, 6(11): 101187 DOI: 10.1016/j.jhepr.2024.101187

Hepatocellular cancer surveillance in patients with advanced chronic liver disease NEJM Evid 2024, 3(11):EVIDoa2400062 DOI: 10.1056/EVIDoa2400062

Open Access A robust clustering strategy for stratification unveils unique patient subgroups in acutely decompensated cirrhosis J Transl Med 2024, 22(1): 599 DOI: 10.1186/s12967-024-05386-2

Distinct immunometabolic signatures in circulating immune cells define disease outcome in acute-on-chronic liver failure Hepatology 2024 DOI: 0.1097/HEP.0000000000000907

Open Access Albumin reprograms the B cell transcriptional landscape and improves neutrophil antimicrobial function in patients with decompensated cirrhosis JHEP Reports, 6 (11): 101184 DOI: 10.1016/j.jhepr.2024.101184

Articles

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Scientific publications and communications

Open Access State of the art and the future of microbiome-based biomarkers: A multidisciplinary Delphi consensus Lancet Microbe 2024: 100948 DOI: 10.1016/j.lanmic.2024.07.011

Open Access Recent advances in the prevention and treatment of decompensated cirrhosis and acute-on-chronic liver failure (ACLF) and the role of biomarkers Gut 2024 DOI: 10.1136/gutjnl-2023-330584

Open Access Prognosis algorithms for acute decompensation of cirrhosis and ACLF Liver Int 2024DOI: 10.1111/liv.15927

Bridging the critically ill patient with acute to chronic liver failure to liver transplantation Am J Transplant 2024, 24(8): 1348–1361 DOI: 10.1016/j.ajt.2024.03.026

Open Access Acute liver failure: A practical update JHEP Rep 2024, 6(9): 101131 DOI: 10.1016/j.jhepr.2024.101131

Reviews

Protocol

Open Access Personalised human albumin in patients with cirrhosis and ascites: design and rationale for the ALB-TRIAL – A randomised clinical biomarker validation trial BMJ Open 2024, 14(2): e079309 DOI: 10.1136/bmjopen-2023-079309

Research outputs

Open Access Acute and non-acute decompensation of liver cirrhosis (47/130) Liver Int 2024 DOI: 10.1111/liv.15861

Open Access Terlipressin therapy is associated with increased risk of colonisation with multidrug-resistant bacteria in patients with decompensated cirrhosis Aliment Pharmacol Ther 2024, 59(7): 877–888 DOI: 10.1111/apt.17899

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