title: http://www.D-MELD.com, the Italian survival calculator to optimize donor to recipient matching and to identify the unsustainable matches in liver transplantation.
abstract: 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 http://www.D-MELD.com. 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 Aruba.it. 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 90days, 1year, 3years, 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 D-MELD.com 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.
authors.affiliation: Department of Surgery, General Surgery and Transplantation Unit, A. Gemelli Hospital, Catholic University, Rome, Italy. alfonso.avolio@rm.unicatt.it
authors.forename: Alfonso W
authors.initials: AW
authors.lastname: Avolio
authors.forename: Salvatore
authors.initials: S
authors.lastname: Agnes
authors.forename: Umberto
authors.initials: U
authors.lastname: Cillo
authors.forename: Maria C
authors.initials: MC
authors.lastname: Lirosi
authors.forename: Renato
authors.initials: R
authors.lastname: Romagnoli
authors.forename: Umberto
authors.initials: U
authors.lastname: Baccarani
authors.forename: Fausto
authors.initials: F
authors.lastname: Zamboni
authors.forename: Daniele
authors.initials: D
authors.lastname: Nicolini
authors.forename: Matteo
authors.initials: M
authors.lastname: Donataccio
authors.forename: Alessandro
authors.initials: A
authors.lastname: Perrella
authors.forename: Giuseppe M
authors.initials: GM
authors.lastname: Ettorre
authors.forename: Marina
authors.initials: M
authors.lastname: Romano
authors.forename: Nicola
authors.initials: N
authors.lastname: Morelli
authors.forename: Giovanni
authors.initials: G
authors.lastname: Vennarecci
authors.forename: Chiara
authors.initials: C
authors.lastname: de Waure
authors.forename: Stefano
authors.initials: S
authors.lastname: Fagiuoli
authors.forename: Patrizia
authors.initials: P
authors.lastname: Burra
authors.forename: Alessandro
authors.initials: A
authors.lastname: Cucchetti
mesh_terms: D000465:Algorithms; D003661:Decision Support Techniques; D046148:Donor Selection / Q000379:methods*; D006085:Graft Survival; D006801:Humans; D020407:Internet; D007558:Italy; D016031:Liver Transplantation / Q000379:methods* / Q000401:mortality; D016015:Logistic Models; D011379:Prognosis; D016019:Survival Analysis