Historically, organs recovered for transplant have been transported using static cold preservation. However, newer portable ex vivo organ perfusion (PEVOP) strategies allow warm organ perfusion during transport. Although PEVOP is a complex process requiring additional staffing resources, few publications address the staffing requirements for this technology. To clarify this issue, we surveyed all 35 United States institutions with PEVOP programs in 2020 and again in 2025 about organization, staffing, and training. We achieved a 100% response rate in both years. The number of institutions with active PEVOP programs decreased from 35 in 2020 to 31 in 2025, while the number of organ platforms increased from 52 to 56. The proportion of platforms operated by manufacturers surged from 17.3% to 96.4% (p < 0.00001), while the percentage run by physicians dropped from 51.9% to 6.7% (p = 0.00174). Challenges to adequate PEVOP staffing, including administrative and financial burdens, as well as staff reluctance, remained consistent across surveys and were significant barriers to its use. These findings may assist institutions in developing strategies to meet the future needs of the workforce while maximizing the safe and effective use of this innovative technology.