Liver transplantation is challenged by organ scarcity and ageing donors. Machine perfusion is a promising technique to enhance organ preservation and assessment, improving liver utilization and patient outcomes. Here, we discuss current practices in machine perfusion using the IDEAL framework and outline the steps needed to advance this technology clinically.
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D.N. and C.D.L.C. have received consultancy income from OrganOx for assisting with the design and conduct of previous trials. P.J.F. is a co-founder and shareholder in OrganOx and received consultancy payments as non-executive chief medical officer of the company. R.J.P. has received speaker’s honoraria and travel support paid to the institution by XVIVO and Aferetica. V.E.d.M. has received speaker’s honoraria paid to the institution by Astellas, Chiesi and XVIVO. O.B.v.L., P.D. and G.C.O. declare no competing interests.
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van Leeuwen, O.B., Nasralla, D., Ceresa, C.D.L. et al. The IDEAL framework for machine perfusion in liver transplantation. Nat Rev Gastroenterol Hepatol 22, 669–671 (2025). https://doi.org/10.1038/s41575-025-01085-5
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DOI: https://doi.org/10.1038/s41575-025-01085-5
