Necroptosis is a newly described form of necrotic cell death induced under conditions where apoptosis was prevented. Necroptotic cell death is characterized by the same morphological features as unregulated necrotic death and induces intense inflammation. A new class of therapeutics called necrostatins can block this. New necrostatins, necrostatin-3 and necrostatin-5, target the RIP1 kinase step in the necroptosis pathway, but through mechanisms distinct from that of the original necrostatin-1. As a class, these new therapeutics have not been tested in transplantation but may hold a key position in blocking organ injury through control of necrosis. Understanding the basic biology of programmed necrosis in organ injury and applying these new therapeutics represent a potentially huge paradigm shift in managing organ injury, donor preservation and transplant survival.