Liver transplantation is now rapidly developing and gaining popularity in our country, and new medical advances from the news papers are coming to us all at once. For patients with serious liver diseases, they may have learned something about liver transplantation from their doctors and patients. It is also common to see liver reports from newspapers and news. However, many patients with liver disease still do not know when to choose liver transplantation, and are unclear about who to believe and where to consult regarding liver transplantation dangers and prognosis claims. Many patients with liver disease should miss the best time for transplantation. When transplantation is finally chosen, many patients with a large number of previous ineffective treatment costing huge amounts of money, other surgeries and invasive treatments increase the difficulty and risk of surgery, and even become contraindicated. Correct timing of liver transplantation is sometimes difficult. However, the lack of knowledge about liver transplantation and the aimless superstition about a certain treatment is sad. The right choice of medical institution patients should have a clear understanding of their liver disease. This is not the same as learning a lot of medical knowledge on your own. Medicine is complex and paperwork is a missed opportunity. Receiving systematic treatment in a regular hospital is a prerequisite for everything, and listening to the competent doctor’s assessment of your situation. In principle, if after a period of ineffective treatment the liver disease has a tendency to worsen and can become life-threatening within two years, liver transplantation should be considered immediately. In this case, you can continue to consult your physician about the progress and prognosis of the disease, but you should consult a regular transplantation center about liver transplantation and not abandon the treatment hastily just by taking the advice of a non-transplantation specialist. Currently, liver transplantation is the ultimate treatment for end-stage liver disease and is one of the most effective treatments. The Ministry of Health of China clearly stipulates that only centers qualified for transplantation are allowed to accept transplantation-related medical activities, in other words, centers that are not qualified for liver transplantation are not allowed to conduct liver transplantation consultations and make presumptuous claims about the success or failure of transplantation surgery. Liver transplantation has now had a fairly widespread impact, and the procedure is available at several centers in China. When choosing a center experienced in surgery for consultation, it is important to pay attention to the qualifications of the center and the soundness of the post-surgical follow-up system, because liver transplantation is more than a simple surgical operation and should be followed up for the expected 10 years after surgery. Therefore, the evaluation of the patient before surgery should certainly not be limited to whether the surgery can be performed successfully. It is very important to prevent the diagnosis of various related diseases after surgery. Patients with these high-risk factors prior to surgery should be screened and clearly informed. Overcoming psychological misconceptions Patients and their families’ own efforts are crucial if they want to achieve satisfactory outcomes. Medical institutions only give guidance on treatment and medication use. However, the ability to cooperate closely with the treatment, the awareness of their own symptoms, and the correct understanding of the exacerbation of the disease. Transplantation is evolving rapidly, and many problems that were ineffective or insurmountable just a few years ago may have changed dramatically. This is the case with liver transplantation, which has changed from the pursuit of simple survival to the pursuit of long-term patient survival and the rational allocation of organs. Many patients who previously considered transplantation experimental in nature and non-clinical routine treatment miss the boat. They may also be influenced by the poor prognosis of other patients after transplantation and hastily abandon transplantation. It is common to lose sight of the truth, but unacceptable when it occurs in the realm of life. Almost all patients choose transplantation after a detour. The financial and physical impact of unnecessary treatment is enormous. There are many ways to treat the symptoms of portal hypertension after cirrhosis, TIPPS shunts, splenectomy dissection surgery, all of which only relieve symptoms and are not necessary treatments to try before transplantation, but instead greatly increase the difficulty of the procedure. Some patients cannot be reoperated due to postoperative development of extensive portal systemic thrombosis. If within 2 years after the aforementioned surgery, another transplantation option has to be chosen, then the previous treatment is an added burden. One should not lose confidence in one’s disease because of its temporary aggravation of symptoms and have to consider transplantation as a life-saving straw. Some patients with chronic hepatitis come to the clinic with abnormal liver function but can still carry out normal daily life. Such patients are often very concerned and worried about the changes in biochemical and viral laboratory indicators due to their liver disease. However, they are equivalent to liver transplant recipients and they do not yet have indications for liver transplantation. It should be clear that only a fraction of patients with viral hepatitis are in danger of eventually leading to cirrhosis, and not all patients with cirrhosis are in need of liver transplantation for life-threatening conditions. Although after liver transplantation, the patient’s hepatitis B is close to cure (hepatitis B surface antigen HBsAg turns negative), the psychosocial stress caused by hepatitis should not be solved by excessive medical treatment, after all, this is a great risk for life and physical health. Treatment of liver disease for economic reasons false and across the board is everywhere. There are some of these treatments that have some efficacy. However, it should be recognized that there is a certain pattern of liver disease progression and current conservative treatments can delay or even stop the disease progression and cannot reverse the disease outcome. A sclerotic liver cannot be restored to normal. Even regular medical treatment only stabilizes the patient’s condition and delays the appearance of a life-threatening condition. Just as kidney patients are kept alive by dialysis treatment, blood purification means such as plasma exchange and blood perfusion are only auxiliary means to stabilize the patient’s condition and have no therapeutic effect on a failing liver, while the results are hardly satisfactory. In the case of truly rapidly progressing liver diseases such as severe hepatitis, they can mostly be fatal within a short period of time. It is important not to have illusions about the prognosis of the patient because of his previous health or temporary stability. You should heed the advice of your doctor. After the development of renal failure and coma due to liver failure, the treatment becomes very dangerous and the success rate of transplantation is greatly reduced. Some patients who had even a slim chance of survival before surgery miraculously recovered their health after transplantation. But this should not turn liver transplantation into a myth. It is easy to be discouraged in the midst of illness and to believe in the miraculous efficacy of treatment. The effectiveness of liver transplantation should not be treated as a myth. Although giving up liver transplantation is equivalent to giving up the last chance of life for many patients, fearless or even harmful treatment, besides being accompanied by huge medical expenses, also leads to the waste of medical resources and human organs. The presence of extra-hepatic metastases from liver malignancies, the presence of severe systemic infections that cannot be controlled or the presence of life-threatening diseases that cannot be cured by liver transplantation should be considered as absolute contraindications to liver transplantation. Performing liver transplantation at this time is only a self-deceptive treatment. Overcoming psychological misconceptions and choosing the right medical institution is necessary for patients to choose liver transplantation. It is also a prerequisite for all medical treatments. It is not objective to expect a high level of medical understanding for the majority of patients, so here is a list of contraindications, risks and considerations for liver transplantation.