Liver transplantation is a highly effective treatment not only for acute or chronic liver failure but also for primary liver cancer such as hepatocellular carcinoma, perihilar cholangiocarcinoma, intrahepatic cholangiocarcinoma, and metastatic tumors such as from neuroendocrine or colorectal liver metastases. The success strongly relies on strict adherence to stringent selection criteria, which lead to excellent outcomes, while previously regarded as contraindication for liver transplantation. These impressive results are, however, mostly achieved with a combination of pretreatment strategies and convincing control of the tumor growth prior to transplantation, as well as minimizing long-term immunosuppression. With this emergence of oncologic liver transplantation, we expect an increasing need of grafts, and therefore included in this report strategies to improve the number of available grafts by maximizing liver utilization rates. Modern machine liver perfusion approaches may play in this respect an important role.