Italy was lacking standardised procedures for donor safety evaluation. We developed practice guidelines, while a panel of experts coordinated by the National Transplant Centre, is available 24 hours a day to support decisions in difficult cases. The guidelines identify five levels of risk and give recommendations for the utilization of donors with HBV and HCV infections as well as for malignancies with negligible or very low risk of transmission. In conclusion we aim to standardize the process of donor evaluation across Italy, to increase the pool of utilised donors and to reduce the risk of communicable disease transmission.