, the Italian survival calculator to optimize donor to recipient matching and to identify the unsustainable matches in liver transplantation


  • Conflicts of interest
    All the authors of this manuscript have no conflicts of interest to disclose.

Alfonso W. Avolio, Department of Surgery, General Surgery and Transplantation Unit, “A. Gemelli” Hospital, Catholic University, Rome, Italy. Tel.: 06 30154437; fax: 06 3010019; e-mail:


Optimization of donor-recipient match is one of the exciting challenges in liver transplantation. Using algorithms obtained by the Italian D-MELD study (5256 liver transplants, 21 Centers, 2002–2009 period), a web-based survival calculator was developed. The calculator is available online at the URL The access is free. Registration and authentication are required. The website was developed using PHP scripting language on HTML platform and it is hosted by the web provider For a given donor (expressed by donor age) and for three potential recipients (expressed by values of bilirubin, creatinine, INR, and by recipient age, HCV, HBV, portal thrombosis, re-transplant status), the website calculates the patient survival at 90 days, 1 year, 3 years, and allows the identification of possible unsustainable matches (i.e. donor-recipient matches with predicted patient survival less than 50% at 5 years). This innovative approach allows the selection of the best recipient for each referred donor, avoiding the allocation of a high-risk graft to a high-risk recipient. The use of the website can help transplant surgeons, hepatologists, and transplant coordinators in everyday practice of matching donors and recipients, by selecting the more appropriate recipient among various candidates with different prognostic factors.