BAR Score Calculator

Recipient Age

Recipient MELD Score

Portal vein thrombosis (1 pt)

Re-transplantation (1 pt)

Donor Age

Cold Ischaemia Time

BAR Score Variables

Total BAR score range: 0–13. Higher scores indicate greater imbalance between donor quality and recipient risk.

BAR Score	Risk Category	3-Year Graft Survival	Recommendation
≤7	Low	>80%	ECD acceptable — proceed with transplant
8–14	Intermediate	60–80%	ECD with caution — individualised MDT decision
≥15	High	<60%	Avoid ECD if possible — consider waiting for better graft

BAR score is particularly relevant when accepting extended criteria donors (age >60, DCD, high BMI, steatosis >30%) where graft quality is a concern
Developed and validated from analysis of 1,060 liver transplants in Basel and Zürich — published in Annals of Surgery 2011
The core concept is counterbalancing: a high-risk donor should only be accepted for a low-risk recipient to optimise overall graft and patient outcomes
SOFT score (recipient factors only) and DRI (donor factors only) provide complementary information; BAR integrates both dimensions in a single score
BAR does not account for warm ischaemia time (relevant in DCD donors), donor steatosis grade, or the impact of machine perfusion technologies
Machine perfusion (hypothermic or normothermic) may safely expand the use of extended criteria donors beyond BAR thresholds — reassessment after viability testing is recommended
In the Eurotransplant setting, ET-DRI and recipient SOFT score together provide similar information to the BAR score

Dutkowski P, et al. Are there better guidelines for allocation in liver transplantation? A novel score targeting justice and utility in the Eurotransplant zone. Ann Surg. 2011;254(5):745–753.