Purpose of Review <p>The potential of donation after circulatory death (DCD) liver grafts to alleviate the gap between donor liver availability and the growing liver transplant waiting list has long been recognized. Historically DCD liver utilization in the United States (US) has been significantly lower than in Europe. Concerns about high rates of biliary complication and inferior graft survival have been the main drivers for lower utilization rates with liver grafts from DCD donors.</p> Recent Findings <p>Advanced perfusion techniques such as in situ normothermic regional perfusion (NRP) and ex situ normothermic (NMP) or hypothermic (HOPE) machine perfusion have had a profound impact on increasing DCD liver utilization. All three of these modalities have demonstrated lower rates of ischemic cholangiopathy and improved graft survival compared to static cold storage (SCS). The excellent outcomes with these technologies have allowed transplant programs to safely expanded their donor age and functional donor warm ischemia time criteria. In addition to these technologies, standardizing the DCD procurement process as well as novel ideas such as donor care units (DCU) and developing robust DCD protocols with aggressive “backup” transplant centers identified in advance, have also facilitated increased DCD liver utilization.</p> Summary <p>Through the growing availability of advanced perfusion technologies and through standardization of the DCD procurement process, DCD liver graft utilization can be substantially increased. The present review discusses current and future strategies to optimize liver graft utilization from DCD donors.</p>