The early outcome after liver transplantation (LT) has nowadays become excellent as indeed shown by the one- and five years survival rates of about 90 and 70 to 80 %.

Despite these results still (too) many successfully transplanted patients die of cardiovascular, infectious and tumor diseases whilst having a well-functioning graft. Most such unfortunate outcomes are mainly related to the immunosuppression (IS).

The liver transplant unit of the Catholic University of Brussels has a long-standing interest in the development of minimization of IS in the field of LT.

During this lecture, the several steps necessary to minimize the IS will be discussed. At the end a final note on the actual developments in the search towards operational tolerance in this field will be highlighted.