Transplant-related intensive care treatment after transplantation of visceral organs, in Germany traditionally headed by transplant surgeons, is an integral part of postoperative therapy after liver, pancreas, intestinal, and combined organ transplantation, i.e. pancreas-kidney, liver-kidney, and multivisceral transplantation. Apart from adjustment and monitoring of immunosuppressive therapy, as well as common intensive care issues such as cardiopulmonary disease and complications, the avoidance, early detection, and rigorous treatment of transplant-related problems are the focus of surgical intensive care treatment of transplant patients. In the following article, its role after visceral organ transplantation is described regarding the most frequent transplant-related complications such as technical failure, various kinds of infection, and graft failure with different etiologies.