Factors associated with perioperative renal function impairment and prevention strategies in liver transplant patients. To observe the changes of perioperative renal function in 118 patients with in situ liver transplantation. Preoperatively, we ensured the effective perfusion of the kidney and cleared nephrotoxic substances from the body; intraoperatively, we minimized blood pressure fluctuations, shortened the duration of the liver-free period, and took extracorporeal diversion if necessary; postoperatively, we avoided the application of nephrotoxic drugs and applied small doses of dopamine or nitroglycerin within 24 h according to the blood pressure to effectively protect renal function. Among 118 patients in this group, 21 cases of oliguria occurred on the first postoperative day, and the urine volume was less than 1000 ml/24h despite the application of high-dose furosemide. After stopping ganciclovir and fluconazole, 16 of them recovered to a urine volume of more than 1000 ml/24h within 2-4 d. Six of the 21 patients died, accounting for 46. 2% (6/13) of the total number of deaths, and all 105 recovered patients were discharged with normal creatinine. Effective protection of renal function is an important measure to improve the success rate of liver transplantation.