ORGAN PRESERVATION AND PROCUREMENT: Edited by Gabriel C. OniscuNormothermic ex-situ liver preservation the new gold standardLaing, Richard W.a,b; Mergental, Hyneka,b; Mirza, Darius F.a,b,cAuthor Information aLiver Unit, Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust bNational Institute for Health Research, Birmingham Liver Biomedical Research Unit and Centre for Liver Research, Institute of Immunology and Immunotherapy, Institute for Biomedical Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom cLiver and HPB Unit, Apollo Navi Mumbai Hospital, Mumbai, India Correspondence to Darius F. Mirza, FRCS, Liver Unit, Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham, NHS Foundation Trust, Birmingham B15 2TH, United Kingdom. Tel: +44 0121 371 4638; fax: +44 0121 414 1833; e-mail: [email protected] Current Opinion in Organ Transplantation: June 2017 - Volume 22 - Issue 3 - p 274-280 doi: 10.1097/MOT.0000000000000414 Buy Metrics Abstract Purpose of review Normothermic machine perfusion of the liver (NMP-L) is a novel technology recently introduced into the practice of liver transplantation. This review recapitulates benefits of normothermic perfusion over conventional static cold storage and summarizes recent publications in this area. Recent findings The first clinical trials have demonstrated both safety and feasibility of NMP-L. They have shown that machine perfusion can entirely replace cold storage or be commenced following a period of cold ischaemia. The technology currently allows transplant teams to extend the period of organ preservation for up to 24 h. Results from the first randomized control trial comparing NMP-L with static cold storage will be available soon. One major advantage of NMP-L technology over other parallel technologies is the potential to assess liver function during NMP-L. Several case series have suggested parameters usable for liver viability testing during NMP-L including bile production and clearance of lactic acidosis. NMP-L allows viability testing of high-risk livers. It has shown the potential to increase utilization of donor organs and improve transplant procedure logistics. Summary NMP-L is likely to become an important technology that will improve organ preservation as well as have the potential to improve utilization of extended criteria donor livers. Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved.