Organ transplantation methodologies are advancing with improved preservation and recovery techniques aimed at increasing graft viability and patient survival. Normothermic regional perfusion (NRP) is gaining traction for liver transplantation, enhancing preservation of organs from donors after circulatory death. Concurrently, studies address donor-recipient genomic mismatches impacting kidney transplant success. Emerging guidelines stress the impact of transplant center volumes even during non-traditional hours. These developments aim to optimize transplantation efficacy and expand organ utilization ethically and effectively.