Calculators › SOFT Score

SOFT Score

Survival Outcomes Following Liver Transplantation
Predicts the probability of 3-month graft survival based on recipient characteristics at the time of transplantation. Developed from UNOS registry data; helps identify high-risk recipients who may not benefit from marginal grafts.
Liver Transplantation Graft Survival Recipient Risk Hepatology
SOFT Score Calculator

Recipient Factors (SOFT)

Donor Factors (P-SOFT add-on)

SOFT Score Variables

VariableCategoryPoints
Recipient Age18–40 years0
41–50 years2
51–60 years4
61–70 years6
>70 years8
(Scored continuously by decade)
Prior abdominal surgeryYes1
Diabetes mellitusYes2
Hospitalised at transplantYes2
Life support (ICU/ventilator)Yes5
Dialysis within 2 weeksYes3
Previous liver transplantYes4
Cause of liver failureAcute liver failure3
Other (ALD/HCV/NASH/HCC)0
MELD Score6–110
12–172
18–234
24–296
30–358
36–41 / >4110 / 12

P-SOFT (Predictive SOFT)

P-SOFT adds donor-related factors to the recipient-based SOFT score, enabling a combined donor-recipient risk assessment before organ acceptance:

Donor FactorCategoryAdditional Points
Cold Ischaemia Time<12 hours0
12–24 hours+3
>24 hours+6
Donor Age<40 years0
40–59 years+2
≥60 years+4

P-SOFT = SOFT + CIT points + Donor Age points. P-SOFT is used when the graft has been offered and donor details are known; it provides a combined estimate of outcome probability.

Interpretation

SOFT ScoreRisk3-Month Graft SurvivalGuidance
≤20Good prognosis>80%Suitable for most graft offers including marginal donors
21–30Moderate risk70–80%Caution with marginal grafts; consider DRI/ET-DRI of specific offer
≥31Poor prognosis<70%Decline marginal graft — accept only ideal standard criteria donors

Clinical Application

  • SOFT score focuses solely on recipient factors — ideal for deciding how much donor risk can be accepted for a given recipient prior to knowing which specific graft is available
  • Patients with SOFT ≥31 should receive the lowest-risk available graft; marginal or extended criteria donors should be declined regardless of urgency
  • Life support (SOFT +5) and acute liver failure (SOFT +3) are the highest-weighted individual recipient risk factors
  • MELD ≥36 adds 10–12 points to SOFT, making MELD the dominant continuous contributor in critically ill patients
  • Used in conjunction with BAR score (donor + recipient combined) and DRI (donor only) for complete donor-recipient matching analysis
  • The original SOFT derivation used 3-month graft survival as the endpoint — not 1-year survival — reflecting the critical early post-transplant period

References

  1. Rana A, et al. Survival outcomes following liver transplantation (SOFT) score: a novel method to predict patient survival following liver transplantation. Am J Transplant. 2008;8(12):2537–2546.

Related Calculators

BAR Score Donor Risk Index MELD Score