Liver transplantation in patients with Acute-on-Chronic liver failure
Research type
Research Study
Full title
Liver transplantation in patients with CirrHosis and severe Acute-on-Chronic Liver Failure (ACLF): iNdications and outComEs (CHANCE) Study on behalf of the EASL-CLIF Consortium
IRAS ID
289953
Contact name
Rachel Westbrook
Contact email
Sponsor organisation
European Foundation for the Study of Chronic Liver Failure.
Duration of Study in the UK
3 years, 0 months, 1 days
Research summary
Acute-on-Chronic Liver Failure (ACLF) is a critical illness developing in some people with chronic liver disease who develop progressive organ failure with a high short-term mortality despite aggressive supportive care. To date, treatment options have been limited but Liver Transplantation (LT) is now recognised as a potential lifesaving treatment for some people with ACLF. However, it has limited availability and many uncertainties regarding its use for ACLF remain. Survival is inferior to standard elective LT and it is unclear how to identify those patients who will benefit from such surgery and those in whom it is futile, as they will inevitably die. We need to understand how best to match individual patients with an ideal liver graft, the detail of the physical and immunological processes that occur and what forms of pre- and post- operative care have the best survival. To do this we will perform a detailed study of people with severe ACLF (classified as Grades 2 and 3) who do and do not undergo LT, making additional comparison with people with severe liver disease but who have not progressed to develop ACLF.
The study is part of a global, prospective observational cohort study aimed at understanding the role of liver transplantation in patients with severe Acute on Chronic Liver Failure (ACLF). It will include 45 European LT centres and a total of 70-80 LT centres worldwide. It is coordinated and sponsored by The European Foundation for the Study of Chronic Liver Failure, (EFClif), in collaboration with the International Liver Transplantation Society (ILTS) and the European Liver and Intestine Transplant Association (ELITA).REC name
London - South East Research Ethics Committee
REC reference
21/LO/0052
Date of REC Opinion
24 Mar 2021
REC opinion
Further Information Favourable Opinion