BACKGROUND (1):  Match or Mis-Match & D-MELD
- Donor-recipient match is a matter of debate in liver transplantation. The intentional combination of donor-related and recipient-related risk factors may offer a new therapeutic strategy with important effects on survival. Sometimes the match or mis-match is purely the result of chance. Nevertheless, in the majority of cases surgeons and hepatologists can take the opportunity to combine organ and recipient on the basis of specific risk assessment methods.
Avolio A.W., Nardo B., Agnes S., Frongillo F., Cavallari A., Castagneto M.: The mismatch choice in liver transplantation: a suggestion for the selection of the recipient in relation to the characteristics of the donor. Transplant Proc 2005; 37:2584-6
The hypothesis that the donor-recipient match may have an even greater intrinsic predictive role than that of the quality of the donor organ, or severity of the recipient disease, has recently been supported by the introduction of the D-MELD. D-MELD is the arithmetical product of donor age and biochemical MELD. D-MELD allowed us to identify the two populations of donor-recipient pairs in whom an extreme match was performed (i.e. low-risk organ transplanted in low-risk pt and high-risk organ transplanted in high-risk pt), to investigate how these extreme matches affect the prognosis, and to improve the model with covariates.
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  • BACKGROUND match or mis-match & D-MELD
  • BACKGROUND futile transplant & futile match
  • D-MELD stratification in deciles and classes
  • RESULTS logistic regressions
  • RESULTS Cox regressions
  • D-MELD prediction of FUTILE MATCH
  • Coordination and registration of website by dr. Alfonso Avolio Dept of Surgery – Transplant Center, Rome Catholic Univeristy -