Our Fulvestrant results showed that the whole complication incidence and acute rejection incidence after ILT were higher than that after CLT. Though biliary complication incidence after ILT was on the increase compared to that after CLT, it did not show statistical difference since its OR scope contained 1. One explanation is that the number of studies included in biliary complication subgroup was relatively small. Another factor is that authors were reluctant to report their high complication incidence results, and willing to share their successful experience. Several reports indicated that administration of rituximab and plasmapheresis before transplantation can reduce the incidence of antibody-mediated rejection both in DDLT and LDLT.Using the therapeutic regimen of perioperative plasmapheresis, intrahepatic arterial infusion, splenectomy, and triple- or quadruple-drug therapy containing calcineurin inhibitor, steroid, and cyclophosphamide, azathioprine, or MMF, the survival rate after ILT has been promoted greatly. Hanto reported that there was no immunological graft loss using total plasma exchange, splenectomy, and quadruple immunosuppression. To our knowledge, this is the first comprehensive review of this topic. We believe our search strategy was sufficient and included all relevant articles. Several reviewers attended to identify all these articles and we used subgroup analysis, which minimized potential selection biases and ensured accuracy of the abstracted data. Our systematic review has several limitations. First, there was no randomized studies on our topic, all of them were observational studies. And there was only one article clearly stated its matchcontrol method in collecting its original data. Second, the number of included studies and participants in each subgroup analysis was relatively small. Third, some subgroups had relatively high sensitivity, which was mainly caused by the relatively larger study size from the study of Stewart. It was a national registry analysis from the United States. However, we failed to get similar registry reports from other Europe or Asia. Otherwise, the analysis result might be more comprehensive and representative. The meta-analysis results of these three subgroups should be carefully concluded. Fortunately, it did not affect the pooled results of total graft survival rate and patient survival rate. In order to get convinced results, more large scale of statistical data and Randomized-Control Study should be needed. Fourth, we did a mixed analysis and did not differentiate LDLT or DDLT. Because most studies only had mixed results and the information in each group was insufficient for analysis. Fifth, potential bias has several considerations: included studies were non-randomized researches; the study sizes were relatively small; the relatively high heterogeneity among studies; some subgroups included only a few studies; chance related bias.