Over the last decade, liver transplantation has become the treatment of choice of end stage chronic liver diseases and acute hepatic failure. However, once this surgical technique was mastered, widespread application of liver transplantation revealed its Achilles' heel: complicated surgery especially with the need for veno-venous bypass, limited surgery because of graft scarcity, excessively radical surgery in case of liver transplantation for acute and potentialy reversible liver failure. Improved techniques were necessary to meet these new requirements generated by the success of liver transplantation. We present alternative techniques to the veno-venous by-pass, techniques of reduced-size and split liver grafts, liver transplantation from living related donor and auxiliary liver transplantation.