Due to higher vulnerability and immunogenicity of extended criteria donor (ECD) organs used for organ transplantation (Tx), the discovery of new treatment strategies, involving tissue allorecognition pathways, is important. The implementation of machine perfusion (MP) led to improved estimation of the organ quality and introduced the possibility to achieve graft reconditioning prior to Tx. A significant number of experimental and clinical trials demonstrated increasing support for MP as a promising method of ECD organ preservation compared to classical static cold storage. MP reduced ischemia–reperfusion injury resulting in the protection from inadequate activation of innate immunity. However, there are no general agreements on MP protocols, and clinical application is limited. The objective of this comprehensive review is to summarize literature on immunological effects of MP of ECD organs based on experimental studies and clinical trials.

由于用于器官移植（Tx）的扩展标准供体（ECD）器官具有更高的脆弱性和免疫原性，因此发现新的治疗策略（涉及组织同种异体认知途径）非常重要。机器灌注（MP）的实施导致对器官质量的评估得到改善，并引入了在Tx之前实现移植物修复的可能性。大量的实验和临床试验表明，与经典的静态冷藏相比，MP作为一种有前途的ECD器官保存方法越来越受支持。MP减少了缺血再灌注损伤，从而保护了自身免疫功能。但是，关于MP协议尚无一般协议，并且临床应用受到限制。