 Live donation. Most live organ donations have a designated recipient, usually a relative or friend (Baily et al. 2020). Usually the designated recipient is not the person who would have got the organ if it were allocated via the method for deceased donor organs. Transplantation systems could refuse such offers for the sake of their normal allocation principles—but they do not. One obvious sufficient reason is that, if the organs were not allocated to the person the donor designates, the donor would not donate and an organ would be forgone.