Sebastian G Michel,1 Joren C Madsen2,3 1Department of Cardiac Surgery, Ludwig-Maximilians-University, Munich, Germany; 2Department of Surgery, Center for Transplantation Sciences, 3Division of Cardiac Surgery, Department of Surgery, Massachusetts General Hospital, Boston, MA, USA Abstract: The purpose of this review was to provide an update on hypothermic oxygenated perfusion as a preservation technique for whole organ allografts. Clinical and experimental data in heart, lung, liver, kidney, and pancreas/islet transplantation are summarized with a special emphasis on marginal donors and donation after circulatory death. The rationale behind hypothermic machine perfusion as well as its advantages and disadvantages compared to conventional cold storage and the competing technique, normothermic machine perfusion, are reviewed. Keywords: organ transplantation, organ preservation, hypothermic perfusion