Sasaki doesn't make the list of top 10 closers because he has been proven to be too injury prone and unreliable. That's the same reason why I don't think Izzy belongs there either. I wouldn't want Sasaki or Izzy as my closer, whether it's a real life team or fantasy team because you never know when they will injure themselves with suitcases and the like. Nen and Hoffman don't make the list because they are both recovering from season-ending surgery; if they rebound to their pre-suregery form next year. Benitez is no longer a closer and won't necessarily be closing next year, so he doesn't qualify.
I agree that MacDougal is nowhere close to being a top 10 closer. He is a terrible closer and a disaster waiting to happen. If he doesn't rein in his walks, wild pitches, and hits batsmen, he will implode completely one of these days. If the Royals make the playoffs, I just can't see them trusting this guy to close out games. I'd use Leskanic before I'd use MacDougal in the playoffs.