Selection of patient for liver transplantation is difficult and important. There are certain markers of hepatobiliary disease as an increase of the blood concentrations of enzymes specifically AST, SGOT, ALT and SGPT. Renal dysfunction and hepatorenal syndrome is common and water retention is mainly due to enhanced ADH activity. While PGE2 and Kallikriens play a compensatory protective role. The blood bank should be notified before surgery and an adequate amount of packed R.B.C. and FFP inside the operating room. ICP monitoring and the use of hyperventilation, osmotic diuresis and barbiturate are mandatory during OLT. Recently organ preserved in UW solution are less likely to exhibit primary non-function.