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With the increasing number of patients waiting for liver transplantation, donor shortage has become a serious problem. The use of grafts from marginal donors and donors after cardiac death (DCD) would greatly contribute to the expansion of the donor organ pool. The benefits of hypothermic oxygenated machine perfusion (HOPE) in many clinical trials have been reported. On the other hand, normothermic machine perfusion (NMP) has been also performed and demonstrated to improve graft function. The application of preservation solution with artificial oxygen carrier solution under subnormothermic machine perfusion for marginal liver graft was shown. Furthermore, long-term maintaining of graft function or recovery by NMP enables ex vivo cell and gene therapy. Thus, machine perfusion technology may alleviate the not only preservation of marginal graft but also new ex vivo bioengineering. [ABSTRACT FROM AUTHOR]