Organ transplantation was one of the most brilliant achievements of clinical medicine in the 20th century, and it revolutionized the field of medicine. It has become the most effective and fundamental way to save the lives of patients with end-stage organ diseases. To date, following kidney transplantation, more than 800,000 people worldwide have received various transplants, including liver transplantation, small intestine transplantation, lung transplantation, and heart transplantation, with long-term survival rates increasing year by year, resulting in tens of thousands of long-term surviving transplant groups. As with other organ transplants, liver transplantation has been a long process of discovery, and in 1963, American physician Tohmas E Starzl encountered a difficult patient. This was a 3-year-old boy with congenital biliary atresia. On arrival at the hospital, the patient was already in a very dangerous condition: severe jaundice, severe liver impairment, and various serious complications including coagulation disorders. To save the child’s life, Dr. Starzl thought of a liver transplant, which could restore the child’s health if the liver, which had no bile duct and was already severely damaged, could be replaced with a healthy, normal liver. After careful consideration, on March 1, 1963, Starzl performed the first ever liver transplant on this patient. The operation was extremely difficult, as the liver lesion caused an almost complete blockage of the portal vein, resulting in very high pressure in the small veins of the abdominal tissues, so that during the cutting of the tissues, blood continued to pour out of the severed vessels, and the patient unfortunately died during the operation because of uncontrolled bleeding. Despite the lack of success, there is no doubt that this was the beginning of a new era in transplantation surgery, and thus the beginning of the history of clinical liver transplantation. On July 23, 1967, Starzl performed a liver transplant on a 1.5-year-old patient with liver cancer, and this time it was successful. He became the first person in history to receive a successful liver transplant. The patient lived for more than 400 days before he died of a recurrence of cancer. However, post-operative rejection was still a major problem for surgeons and patients because no specific immunosuppressant was available at this time; the special structure of the liver also made surgery and post-operative management difficult. When research almost came to a standstill, the advent of azathioprine in 1959 brought hope for organ transplantation. It is an immunotransplantation agent that is still used clinically today, with fewer toxic effects than other similar drugs previously discovered, high immunosuppressive potency, and relatively safe clinical use. On the other hand, adrenocorticosteroids have long been used to suppress excessive inflammation and to treat allergic diseases involving autoimmune reactions, and in 1963, Starzl began to use a combination of azathioprine and prednisone in kidney transplant patients, and as a result, rejection was suppressed in these combined patients. This approach soon became widely used in clinical liver transplantation. The subsequent advent of cyclosporine A (CsA) revolutionized clinical transplantation. It was the first immunosuppressive agent with some selectivity, originally obtained as an antifungal drug from a soil fungus, and later found experimentally to exert an anti-rejection effect by interrupting lymphocyte signaling, which clearly had more advantages than others since it acted mainly on T lymphocytes mediating graft rejection. 1979 saw the first use of Calne in clinical organ transplantation CsA, and in 1980, Starzl demonstrated through animal studies that the combined application of CsA and prednisone could exponentially increase the survival rate of transplanted livers. It was soon discovered that the use of CsA increased the survival rate of liver transplants from 30% to over 70% – a remarkable success indeed. 70% survival rate meant that liver transplants could finally end the long clinical trial period and enter the operating room of a large number of hospitals. Soon after, on June 23, 1983, the NIH’s Bethesda Conference on Liver Transplantation declared that liver transplantation “is no longer an experimental technique and should be promoted in clinical applications. The 1980s and 1990s were a period of rapid development for liver transplantation. During this period, the United States and Europe established a comprehensive and equitable organ allocation network, new technologies such as intravenous transfer and UW preservation fluids emerged, and several large transplant centers were established worldwide. The survival rate of surgery has been improving. In Europe and the United States, the one-year survival rate of liver transplantation is more than 90%, the 5-year survival rate is more than 75%, the 10-year survival rate is 60%, and the longest survivor is more than 30 years. The indications for surgery are expanding, and liver transplantation has been used to treat parenchymal liver diseases, such as post-hepatitis cirrhosis, alcoholic cirrhosis, acute liver failure, chronic active hepatitis, congenital liver fibrosis, cystic liver fibrosis, liver cysts, neonatal hepatitis, Bu-plus syndrome, severe irreversible liver trauma, congenital metabolic disorders, such as a-1 antitrypsin deficiency, Wilson`s disease, glycogen accumulation disease, and hepatocellular carcinoma. Wilson`s disease, glycogen accumulation syndrome, familial non-hemolytic jaundice, etc.; cholestatic diseases: such as congenital common bile duct atresia, primary biliary cirrhosis, sclerosing cholangitis, secondary biliary cirrhosis; and liver tumors. Today, liver transplantation has become the last hope for many patients with end-stage liver disease, and an increasing number of people are regaining their lives thanks to liver transplantation. Since the 1960s, more than 100,000 patients have undergone the procedure worldwide, with the number increasing by more than 10,000 each year. Many patients have achieved long-term, stable survival, and many people who had no hope have returned to their lives in society. This technique has become one of the most acclaimed methods in surgery today, and liver transplantation has become one of the hallmarks of a hospital or even a country’s surgical standards. Liver transplantation in China started late, but has developed very rapidly, and its achievements in recent years have attracted the attention of the international transplantation community.