Ghinolfi, Dondossola, and colleagues from Italy in this issue describe a significant step in utilization of organs that are currently not transplanted. The particular constraints that apply to DCD organ donation in Italy (the requirement for 20 minutes of asystole on ECG) provide the incentive to innovate: this length of warm ischemia effectively precludes conventional organ retrieval. However, the approach described is not only important in Italy but also relevant anywhere DCD liver transplantation (LT) is undertaken .