Letter to The Editor: Reply to: "The concept of Real-Time Spectroscopy for liver viability assessment".

Carvalho et al.(1) raise two issues related to our manuscript.(2) The first addresses our finding that removing blood can reduce liver injury. With an increased utilisation of DCD livers and variable procurement protocols, we sought to investigate whether blood removal prior to the start of normothermic regional perfusion has any effect on liver function. We found that removal of blood led to decreased organ injury as measured by multiple techniques.