The piggyback technique was first described in adult liver transplantation in 1989, although it has been used in conjunction with venous bypass. We compared the use of intraoperative blood product and fluid requirement among patients managed with and without bypass with those in whom the piggyback technique was used. 130 consecutive liver transplants were performed between April 14, 1993 and June 26, 2004, in Shiraz (Southern Iran) organ transplant center in which 120 cases used piggyback technique. We studied the last 40 cases in this investigation. Operation time, fluid consumption and operative outcome were calculated in a mean follow up period of 9 months. 92% of patients were alive with only one operative mortality at the time of study. The mean number of packed RBC units consumed intraoperatively per case was 8.3±3.6, and 3.2±1.6 units of crystalloids were used. Mean Operation time was 125±50 minutes. Graft and patient survival during this period was 92% and 92%; respectively. The piggyback technique requires a longer operation time but offers the advantage of reducing RBC requirements and preventing severe hemodynamic instability by virtue of intraoperative fluids.