To find evidence related to the involvement of humoral factors in liver transplant rejection and to explore rational protocols for clinical monitoring and treatment of humoral rejection. To diagnose the presence of humoral rejection in patients with liver injury by detecting the expression of complement CAd, CD20 (B cells) and CD138 (plasma cells) in liver perforated tissues after liver transplantation. When rejection was diagnosed clinically in combination with pathology, the dosage of tacrolimus (Pulcoflor) was first increased and hormone shock therapy was used for those with severe liver function impairment; after hormone shock therapy was ineffective in patients diagnosed with humoral rejection, anti-thymocyte globulin (ATG) or rapamycin (RPM) was given. Results A total of 25 liver puncture examinations were performed in 16 patients, and pathological examinations were combined with clinical manifestations. 10 patients were diagnosed with humoral rejection 15 times, 4 patients were diagnosed with cellular rejection 6 times, and the other 2 patients were diagnosed with acute and chronic rejection successively. The efficiency of hormonal shock treatment for humoral rejection (29.4%, 5/17) was significantly lower than that for cellular rejection (87.5%, 7/8). 7 patients were diagnosed with hormone-resistant humoral rejection at 12 times of liver damage, and the rejection was corrected in 1 case with ATG treatment and 5 cases with RPM after the failure of hormonal shock treatment, and the other 1 case received The other patient with type “AB” who received type “O” donor liver had 2 significant abnormal liver functions and died of liver failure after various treatments were ineffective. Humoral immune factors may be involved in the development of acute and chronic rejection of some liver transplants. Treatment of humoral rejection with ATG and RPM is more effective.