Your party has slain a hundred monsters and looted a hundred identical coin pouches. Meanwhile the troll's regenerating arm, the basilisk's petrifying eye, and the displacer beast's impossible hide rotted where they fell. Grafts fix that.
Download the Print-Quality PDF →
A graft is a monster part surgically bonded to a willing creature. It grants a fragment of the monster's power — and it always, always costs something. Grafts make every kill a loot table, turn back-alley fleshcrafters into memorable NPCs, and give martial characters progression that isn't just a bigger number.
Harvesting a graft-viable part takes 10 minutes per CR of the creature (minimum 10 minutes) and requires a successful check with leatherworker's tools, an herbalism kit, or a healer's kit — harvester's choice, using Intelligence or Wisdom.
| Creature CR | Harvest DC | On a Failure… |
|---|---|---|
| 0 – 4 | 12 | Part is ruined |
| 5 – 10 | 15 | Part is ruined |
| 11 – 16 | 18 | Part is ruined; harvester takes 2d6 damage of a type the monster dealt |
| 17+ | 21 | As above, and roll on the Rejection table as if grafted |
A harvested part stays viable for 7 days, or 30 days if preserved in salt, alcohol, or a gentle repose spell.
Installing a graft requires a surgeon (any creature proficient in Medicine or with relevant fleshcraft training), 8 hours of surgery, and gold for materials based on the part's tier. The recipient finishes the surgery at 1 hit point and gains one level of exhaustion.
| Tier | Source CR | Surgery Cost |
|---|---|---|
| Minor | 0 – 4 | 150 gp |
| Major | 5 – 10 | 600 gp |
| Dire | 11 – 16 | 2,500 gp |
| Mythic | 17+ | 10,000 gp |
The Strain Rule
A creature can safely carry a number of grafts equal to its Constitution modifier (minimum 1). Each graft beyond that limit imposes one permanent level of exhaustion while installed, and forces a roll on the Rejection table at every dawn. The body keeps score.
Every graft lists its gift and its price. Never waive the price.
Gift: At the start of your turn, regain 3 hit points if you have at least 1 hit point and took no fire or acid damage since your last turn.
Price: You have vulnerability to fire damage while below half your hit point maximum. The arm knows what kills it.
Gift: As an action, force one creature within 30 feet to make a DC 13 Constitution save or be restrained by creeping stone until the end of your next turn. Once used, the eye needs a long rest.
Price: Your reflection is always slightly delayed. Mirrors unsettle you; you have disadvantage on saves against being frightened by anything you see in one.
Gift: The first attack roll made against you each round has disadvantage — you are never quite where you appear to be.
Price: Neither are your allies' spells. Any beneficial spell that targets you fails on a roll of 1–3 on a d20, wasted.
Gift: Objects you grip cannot be disarmed from you, and you have advantage on checks to grapple or climb.
Price: Letting go is a choice your hand doesn't always agree with. When you try to release something under stress, roll a d6 — on a 1, you can't until the start of your next turn.
Gift: Your unarmed strikes deal 1d6 slashing damage, and you have advantage on Wisdom (Perception) checks relying on smell.
Price: Fine work is over. You have disadvantage on checks requiring delicate manipulation — thieves' tools, calligraphy, surgery, buttons.
Gift: Once per short rest, coat a weapon as a bonus action; its next hit deals an extra 2d6 poison damage.
Price: Your own blood carries a trace. Whenever you drop to 0 hit points, you are also poisoned for 1 hour after you regain consciousness.
Gift: You can taste lies. When a creature within 10 feet knowingly speaks a falsehood, you may make a DC 14 Wisdom (Insight) check to notice the flavor of it.
Price: Cooked food tastes like ash to you. Only raw or bloody meals satisfy — and people notice.
Gift: You gain a breath weapon: a 30-foot cone of the dragon's damage type, 8d6, Dexterity save for half (DC 8 + your Con modifier + proficiency). Recharges on a long rest.
Price: The hoard-hunger comes with it. When you see unclaimed treasure, you must succeed on a DC 15 Wisdom save or be unable to take any action except moving toward it on your next turn. Your DM decides what counts as treasure. The gland decides too.
Roll when strain rules demand it, when a graft's host drops to 0 hit points from necrotic damage, or when a cursed or botched surgery says so. Effects last until removed by greater restoration or until the offending graft is removed.
| d10 | The Body Objects |
|---|---|
| 1 | The graft goes numb — its gift is suppressed for 24 hours, its price is not |
| 2 | Fever dreams of the donor creature's death; no benefit from the next long rest |
| 3 | Visible spread — scales, fur, or veining creeps outward; disadvantage on Charisma checks with strangers for a week |
| 4 | The graft twitches toward violence; first attack roll each combat is made with disadvantage as you fight it for control |
| 5 | Appetite shift — you crave what the donor ate; standard rations no longer count as food for you this week |
| 6 | Phantom instinct — you must roll a Wisdom save (DC 12) to willingly approach fire, sunlight, or whatever the donor feared |
| 7 | The seam weeps; maximum hit points reduced by 1d10 until the graft settles (one week) |
| 8 | Your voice doubles for 1d4 days — yours, and something lower underneath it |
| 9 | The graft grows. Its gift improves slightly (DM's choice) and so does its price. Permanently. |
| 10 | Full revolt — the graft must be surgically removed within 7 days or the host gains one permanent level of exhaustion per week it remains |
Introduce grafts through an NPC, not a menu — a fleshcrafter in a butcher's district who pays in surgery instead of coin. Let players discover the catalog one graft at a time on the bodies of enemies. And track every graft's price in your session notes, because the price is the story: the fighter who can't hold a quill anymore, the rogue the mirrors don't trust. Six sessions later, those details pay off — if anyone wrote them down.
Every long-running table quietly stops playing by the book. These are the ten most-adopted house rules we've seen across hundreds of campaigns — each with the r...
Your party has five turns for every one the boss gets. That's why your carefully built villain dies in round two — not bad luck, just math. Phases fix the math...
There are a hundred D&D tools and you need about ten. This is the working set: what each one does, when it earns its place, and the honest tradeoff nobody puts...
There are a hundred D&D tools and you need about ten. This is the working set: what each one does, when it earns its place, and the honest tradeoff nobody puts...
Your party has five turns for every one the boss gets. That's why your carefully built villain dies in round two — not bad luck, just math. Phases fix the math...
Every long-running table quietly stops playing by the book. These are the ten most-adopted house rules we've seen across hundreds of campaigns — each with the r...