The burden of chronic liver disease continues to grow worldwide and the UK is no exception. Consequently, the indications for LT continue to expand with increasing numbers of patients listed (52% increase over the last 4 years in the UK) but a continuing shortage of donor livers. The LT waiting list mortality in the UK is currently 8-22%, comprising patients who die waiting for a transplant or are removed from the list because they become too ill. Besides the national campaigns to increase donor numbers, strategies for increasing the liver donor pool includes a UK wide split liver program and expanding the use of DCD organs. The long term outcome for LT from DCD donors has been considered inferior to organs from DBD donors. However, recent reports suggest comparable outcomes for DBD and DCD livers after transplantation. It is also becoming apparent that the outcome of DCD livers depends on a number of donor and recipient factors and technical factors in relation to the organ retrieval and implantation. Preoperative identification of factors associated with poor outcomes in DCD LT remains an important challenge. The period between extubation and asystole may help predict graft function. Less liver damage may occur if the donor progresses quickly to cardiac death, as opposed to maintaining a heartbeat in the presence of significant hypoxia or hypotension. Consistent with this, restrictions on recovery are now imposed by most UK centres based on donor time to death and the duration of hypoxia or hypotension. This FWIT starts when the systolic blood pressure has a sustained (i.e. at least 2 min) fall below 50 mmHg (or the haemoglobin oxygen saturation falls below 70%) and extends up to the onset of cold in situ perfusion. The duration of the FWIT is the important determinant of outcome. The expected lifetime of a LT candidate offered a DCD liver should be compared with the expected lifetime of that candidate if they were to turn down the DCD offer and continue to wait for a DBD liver. That is to say, even if graft and/or patient survival is lower with a DCD liver, it may be better than dying on the waiting list. Considering the current shortage of donor organs, every liver transplant candidate should be informed at the time of evaluation that the choice in the UK is frequently not between a marginal (including DCD) liver and a standard liver, but between a marginal (DCD) liver or no liver at all. Until an algorithm for the use of the DCD donor is determined, recommendations by transplant teams and decisions by LT candidates should be predicated on full disclosure of the known risks and potential benefits of DCD LT.