Foster et al social criteria, co-morbid substance use, and possibly family history have greater predictive value than the length of abstinence before transplantation. From our own experience and that reported by other teams, we believe that the most important factor in the preoperative period is the acceptance by the patient and his/ her family of his/her alcoholism.22 In addition, since 1995, a psychiatrist has been involved in the evaluation before and the follow up after transplantation, not only to assess psychologi- cal selection criteria, but, above all, to help the patients to understand and to face their alcoholic disease. We have to bear in mind the fear of alcoholic patients that “without the alcohol, they will literally fall apart and cease to function, if not cease to exist”