Advances in surgical techniques, immunology, and organ donor networking have allowed organ transplantation to evolve over the last several decades into a procedure that has saved hundreds of thousands of lives. While these dramatic advances have made organ transplantation more effective, they have also highlighted the growing shortage of donor organs. Unfortunately, many organs that could be of potential use for transplantation end up discarded due to short preservation times, often only 4-12 h for vital organs. Organ preservation systems have been investigated with renewed vigor in attempts to solve this problem, and new tools are becoming available that make solutions much more possible than ever before. The cryobiology of organs must be understood for long-term banking solutions to be feasible, combined with greater understanding of the physio-chemical processes that take place during ischemia and reperfusion. New approaches based on natural models, stem cells, and various novel proteins and trophic factors all show great promise in accomplishing the goal of more donor organs matched with more patients in need.