COMMENT TO "LIVER MATCH: A PROSPECTIVE OBSERVATIONAL COHORT STUDY ON LIVER TRANSPLANTATION IN ITALY"

We believe that DRI, developed on the 1998–2002 north- American donor population, cannot be applied directly to the 2007–2009 Italian population for several reasons. Amongst the 8 factors leading to the calculation of DRI, at least two (race and DCD) are absolutely not applicable considering that in Italy almost all donors are white Caucasians and that DCD is not performed. In addition, in Italy due to the older donors’ age, the prevalence of stroke as death cause is higher whilst the share is more limited due geographical characteristics and smaller dimensions of organ pro- curement areas. Lastly, the preliminary analysis which led to the identification of DRI determinants stated that SPLIT organs were predictive of a less favourable outcome. On the contrary, as pre- viously stated, the SPLIT modality does not represent, in Italy, an unfavourable prognostic factor [6]. In summary, of the parameters analysed, only donor age, donor height and CIT data are compara- ble, even if the coefficients obtained are not strictly applicable to the elderly Italian donor population.