From March, 1979 to March, 1983, 26 orthotopic liver transplantations and 1 retransplantation were performed in our center. Sixteen patients are alive, 5 beyond22 years and 1 longer than 4 years after transplantation. The actuarial 1– and 2–year survival is 60%. Factors contributing to this result are patient selection and biliary anastomosis. In cirrhotic patients, the degree of deterioration of liver function correlated with survival; in patients with hepatocellular carcinoma, extrahepatic spread of tumor was the most frequent limiting factor. Choledochocholedochostomy with a widening plasty had a low complication rate providing that the arterial blood supply was undisturbed. Until now, HLA-matching has not contributed to the result of liver transplantation, although the effect for long-term survival is still unknown. The high survival rate and excellent quality of life of long-term survivors justify liver transplantation as treatment for otherwise noncurable liver diseases.