The Shiraz Liver Transplant Audit collects information on all liver transplantations that are carried out in Iran. In this paper, we describe these transplantations and their outcomes in adult patients according to primary liver disease diagnosis, type of transplantation and period. A prospective cohort study of 364 orthotropic liver transplantations carried out between June 2002 and September 2008 in the Shiraz the west state of Iran. Actuarial survival rates, calculated using Kaplan-Meier method, were compared using the log-rank test. To determine independent prognostic factors for survival, Cox regression model analysis was used. Among the 364 patients included in the study (age 39 13 years; 327 [68.1%] men), the most common causes of liver disease were hepatitis B and C virus infection (25.8). Overall patient survival rates at 1, 2, 5 and 6 years after LT were 83.7%, 82%, 82% and 82%, respectively. Mean and SE of patient was 64.6 ± 1.7(CI95%: 61.2-67.9). Short time and long time survival of these patients in both sex and between age groups was similar. Survival of patients with MELD score above 20 wasn’t changes. Multivariable analysis demonstrated that these improvements only be explained by donors age between 20-40 years old. In summary, OLT has developed into a safe and successful treatment for end-stage liver disease with excellent long-term results, an experience with liver transplantation indicates success comparable to that noted in other reports.