Background: The procurement of the liver is a standardized surgical procedure in the hands of qualified transplantation and organ procurement surgeons which is defined in the German guidelines.
Methods: Literature review and discussion of critical aspects concerning the procurement of liver allografts. The procurement of livers should be performed by qualified transplantation and organ procurement surgeons (certification). The technique is standardized in German guidelines. A thoracotomy can help to optimize exposition which is essential to avoid technical complications and injuries to the graft especially in a training situation. Dissection in the cold is recommended. Knowledge of the anatomic variations of the hepatic artery is essential in procuring liver allografts. Documentation of errors and anatomic variations, packing of organs and a standardized closure of the thorax and abdomen are obligations of the responsible leading organ procurement surgeon.