Cirrhosis from hepatitis C (HCV) is now the most common indication for liver transplant (LT) in the U.S., but between 2004 and 2013, new LT listings for NASH increased by 170%. Unfortunately, fibrosis progression leading to cirrhosis, liver cancer, and liver decompensation continues to occur after transplantation. Once cirrhosis and decompensation are evident, patient survival is poor and repeat LT is considered to improve outcomes. Therefore, the never-ending thirst for new approaches in the management of patients pre- and post-transplant has led to a very promising future in transplantation, thought there is much to learn to achieve better patient outcomes. This issue of Clinics in Liver Disease addresses the core areas to achieve better patient outcomes, with articles devoted to coagulopathy before liver transplant, challenges in renal failure before LT, LT for acute alcoholic hepatitis, LT in the pregnant patient, bariatric surgery and LT,and MELD Scores in prioritization of LT, to name a few. Readers will place a high value on the current state of liver transplantation in this issue.