Recent advances in the field of warm ex-vivo liver perfusion

Purpose of review Organ shortage remains a major obstacle for liver transplantation, resulting in an increased mortality on the liver transplant waiting list. The usage of extended criteria donors (ECD) is a strategy to increase the number of available donor organs, however, with the risk of a higher rate of posttransplant graft dysfunction. Novel preservation strategies, such as warm ex-vivo liver perfusion, could improve the outcome of liver transplantation with ECD grafts. The present review summarizes the advances in the field of warm ex-vivo liver perfusion over the last 12 months. Recent findings The feasibility and safety of warm ex-vivo liver perfusion has been determined in several single center clinical trials. Furthermore, a large phase III multicenter trial demonstrated decreased liver injury and improved graft function in warm perfused versus cold stored grafts. New strategies for graft assessment and modification during machine perfusion have been evaluated with promising results. Summary Warm ex-vivo liver perfusion has been successfully translated into the clinical setting. Recent research is focusing on graft assessment and graft modification during machine perfusion.