Changes in donor liver allotment will not generate more organs. At thi
s time, diverse training and experience are all that guide donor organ
selection. Donor variables are now recognized to influence patient an
d graft survival at 1 year and beyond. Little is known about the molec
ular biology of hepatic ischemia/reperfusion that might enable informe
d donor preparation and selection. This study of South-Eastern Organ P
rocurement Foundation liver transplant centers identifies differences
among liver transplant surgeons in donor assessment as issues for furt
her consideration. Sixteen of 25 centers responded. A 170 mEq/L donor
serum sodium was the upper limit for acceptance. Selection based on do
nor vasopressor use lacked uniformity. Preimplantation donor liver bio
psy was used selectively, and the maximum acceptable fat content was 3
0 per cent for most centers. Donor hospitalization for more than 7 day
s was considered a negative factor by all groups. Surprisingly, five c
enters were not using donor livers testing positive for hepatitis C. T
his study points to the great variability in the assessment of organ d
onors. Greater consensus in this area could lead to increased organ us
e and/or less retransplantation, a net gain in organ economy.