In Germany, there is a critical shortage of donor organs, and the liver transplantation waiting list is characterized by a high mortality rate. The ExTra study – “Pilot, open-label, prospective, randomized, multicenter trial on quality assessment of declined liver grafts by normothermic ex vivo machine perfusion to reduce time to transplantation” – therefore aims to shorten the waiting time for liver transplantation by assessing the quality of declined liver grafts through ex vivo machine perfusion.