Liver transplantation has progressed rapidly from an experimental procedure to standard therapy for patients with end-stage liver disease. However, the demand for liver transplantation far exceeds the supply. As a result, in all countries, there are many deaths per year on the liver transplant waiting list.

The relative organ shortage provides the basis for considering the ethical issues associated with liver transplantation. For example, allocation of organ to patient with alcoholic liver disease, which is one of the most common indications for liver transplantation, is still surrounded by unresolved controversies and ethical dilemma. One critical issue is whether patient’s life style should be taken into account in deciding who gets the organ.

In 1993, supported by several studies, the National Institutes of Health Consensus Conference on Liver Transplantation stated that alcoholic liver disease is an appropriate indication for liver transplantation. This led to an increase in the number of transplants performed for these patients.

By presenting an ethical argument about liver transplantation to patients with alcoholic liver disease, reasons provided by proponent and opponents will be discussed. In doing so, controversy about a second liver transplantation to a patient with alcoholic liver disease will be discussed.