http://www.D-MELD.com, the Italian survival calculator to optimize donor to recipient matching and to identify the unsustainable matches in liver transplantation

被引：28

作者：

Avolio, Alfonso W. ^{[1
]}

Agnes, Salvatore ^{[1
]}

Cillo, Umberto ^{[2
]}

Lirosi, Maria C. ^{[1
]}

Romagnoli, Renato ^{[3
]}

Baccarani, Umberto ^{[4
]}

Zamboni, Fausto ^{[5
]}

Nicolini, Daniele ^{[6
]}

Donataccio, Matteo ^{[7
]}

Perrella, Alessandro ^{[8
]}

Ettorre, Giuseppe M. ^{[9
]}

Romano, Marina ^{[10
]}

Morelli, Nicola ^{[11
]}

Vennarecci, Giovanni ^{[9
]}

de Waure, Chiara ^{[12
]}

Fagiuoli, Stefano ^{[13
]}

Burra, Patrizia ^{[14
]}

Cucchetti, Alessandro ^{[15
]}

机构：

[1] Catholic Univ, A Gemelli Hosp, Gen Surg & Transplantat Unit, Dept Surg, Rome, Italy

[2] Dept Surg & Gastroenterol Sci, Hepatobiliary Surg & Liver Transplantat Unit, Padua, Italy

[3] Univ Turin, S Giovanni Battista Hosp, Gen Surg & Liver Transplantat Unit, Turin, Italy

[4] Univ Udine, Gen Surg & Liver Transplantat Unit, I-33100 Udine, Italy

[5] G Brotzu Univ Hosp, Liver Transplantat Ctr, Cagliari, Italy

[6] Polytech Univ Marche, Umberto I Hosp, Liver Transplantat Ctr, Ancona, Italy

[7] Univ Verona, Maggiore Hosp, Liver Transplantat Ctr, I-37100 Verona, Italy

[8] Cardarelli Univ Hosp, Laparoscop Hepatobiliary Surg Unit, Liver Transplantat Ctr, Naples, Italy

[9] San Camillo Forlanini Hosp, POIT, Liver Transplantat Ctr, Rome, Italy

[10] Cardarelli Univ Hosp, Hepatobiliary Surg Unit, Liver Transplantat Ctr, Naples, Italy

[11] Univ Genoa, S Martino Hosp, Liver Transplantat Ctr, Genoa, Italy

[12] Catholic Univ, Inst Hyg, Rome, Italy

[13] Osped Riuniti Bergamo, Liver Transplantat Unit, Dept Gastroenterol, I-24100 Bergamo, Italy

[14] Univ Padua, Multivisceral Transplantat Unit, Dept Surg & Gastroenterol Sci, Padua, Italy

[15] Univ Bologna, S Orsola Hosp, Dept Gen Surg, Liver & Multiorgan Transplantat Unit, Bologna, Italy

来源：

TRANSPLANT INTERNATIONAL | 2012年 / 25卷 / 03期

关键词：

D-MELD; ethics; expansion of donor pool; marginal donors; MELD; outcome analyses; selection criteria; BENEFIT; ERA; ALLOCATION; MORTALITY; SELECTION; IMPACT; FUTURE; MODEL; TOOL;

D O I：

10.1111/j.1432-2277.2011.01423.x

中图分类号：

R61 [外科手术学];

学科分类号：

摘要：

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, 20022009 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 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 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 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.

引用

页码：294 / 301

页数：8

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