Abstract:Discarded liver refers to functional liver segments separated from resected diseased livers. When used as small-volume grafts in auxiliary liver transplantation, discarded livers provide a novel strategy for expanding the donor pool. In recent years, with the further extension of the discarded liver concept, the rational integration of discarded liver transplantation with staged hepatectomy and other surgical techniques, together with rapid advances in the field of xenotransplantation, has offered additional therapeutic options for patients awaiting liver transplantation. How to achieve innovative clinical applications of discarded livers, as well as the prospects and directions for their wider adoption, has become an important issue in the field of liver transplantation. Based on current domestic and international evidence and the authors'clinical experience, this paper systematically summarizes the technical evolution and current applications of auxiliary liver transplantation using discarded livers, with a particular focus on innovative surgical strategies, the potential clinical value of combining discarded liver transplantation with xenotransplantation, and future perspectives on the safe implementation and individualized surgical decision-making of this approach.