Living donor transplantation has always involved ethical issues, perhaps the most vexing arising from the harm inflicted upon the donor. Non-regenerative organ transplants from living donors intensify these concerns; and none more palpably than living donor liver transplants. Each individual is endowed with but one liver whose anatomy and consistency does not easily lend itself to be shared. Living donor liver transplantation entails considerable short term and long term risks to both the donor and the graft. Donors who willingly expose themselves to those risks deserve the safest methods available. Improved surgical techniques and a better understanding of surgical anatomy help to manage these inevitable hazards. This motion picture illustrates a surgical technique for an adult to adult living donor liver transplant twenty years after this institution hosted the first successful living donor liver transplant.