Rethinking the Liver Donor Risk Index

Trenches in Transplant Surgery · Sep 21, 2026 · 54m

The Number on the Offer: Rethinking the Liver Donor Risk Index

The liver donor risk index helped transplant teams quantify donor-associated graft risk. But an organ-offer decision requires more than a score: it depends on the recipient’s urgency and reserve, procurement findings, preservation and transport, operative complexity, and the consequences of continued waiting.

This episode examines why weak predictive performance does not mean donor biology is irrelevant. Outcomes among transplanted livers already reflect clinical selection, matching, and management—and cannot establish that…