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The imbalance between grafts available for transplantation and demands has moved the focus of many investigators on the search for novel strategies to rescue organs, previously considered to be unsuitable for transplantation. In this setting, machine perfusion is recognized as one of the most significant improvements in the field of transplantation over the past 20 years. 1 Besides potentially improving organ shortage by repairing putative irreversible injuries, dynamic preservation strategies may offer an opportunity to test organ quality before implantation or to manipulate some functions; for example, by mitigating the immune response. 2

For livers, 2 main perfusion approaches are currently debated in the clinic:(a) perfusion with blood or alternative oxygen carriers at physiologic normothermic or subnormothermic conditions, or (b) perfusion with cooled oxygenated artificial fluids. The aim and mechanisms of both …