ABSTRACT
Liver transplantation (LTx) is the standard treatment for end stage liver disease. Current practices in liver preservation are described spanning donor management, liver procurement techniques, preservation techniques and use of extended criteria donor (ECD ) livers. Safe expansion of the donor pool to include elderly, steatotic and donor after cardiac death livers is one of the most pressing challenges facing the field today. Preclinical and clinical developments in liver preservation solutions and agents show promising results to target specific mechanisms and reduce ischemia-reperfusion injury. Combined with exciting developments in machine perfusion, the liver preservation field is poised for significant advances in the coming years, targeting expanded access to ECD livers, greater preservation times, enhanced graft integrity and ultimately, improved patient outcomes.
