In a wide range of acute, debatable problems of transplantology, the problem of donation should be highlighted. It includes the selection and management of the donors, ethical and religious aspects and issues on the prevention, treatment and rehabilitation of the organ before its transplantation. Among the many methods of organ preservation, in the last decade, machine perfusion methods are on the forefront. They are designed to minimize or repair the ischemic-reperfusion damages in tissues and cells. This became possible in conditions of technical progress and the introduction of artificial circulation systems that provide adequate tissue microcirculation in non-heart-beating donors. However, this approach should take into account the complexity of the perfusion machines design, its various connection schemes and the nature of the perfusion parameters - the composition and temperature of the perfusion liquor. Experimental studies confirm that the use of machine perfusion is a technology whose possibilities will radically change the approaches to organ transplantation.